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Although appendicitis has traditionally been treated surgically, a number of studies have demonstrated that most cases can be successfully treated with antibiotics alone (NEJM JW Emerg Med Mar 2020 and JAMA Surg 2020; 155:283). The option of nonoperative management has become especially important in the era of COVID-19, as the American College of Surgeons has recommended that decisions about nonemergent surgical procedures should consider patient preferences and the medical risks of the procedure (https://www.facs.org/covid-19).
These investigators conducted a randomized noninferiority trial to compare outcomes with antibiotics versus surgery in 1552 adults with appendicitis. The primary outcome — scores on the European Quality of Life-5 Dim…