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Emerging evidence suggests that antibiotic treatment alone is a viable alternative to surgery in some patients with appendicitis (NEJM JW Gen Med Jan 1 2021). In this meta-analysis, researchers used individual patient data from six randomized trials to compare antibiotics with appendectomy in 2100 adults with imaging-confirmed acute appendicitis.
Results at 1 year included the following:
About one third (34%) of patients randomized to antibiotics eventually underwent surgery.
Incidence of complications was not significantly different between the antibiotic and appendectomy groups (5% and 8%, respectively).
Among patients with appendicoliths at preintervention imaging, complications were significantly more common in those randomized to antibioti…