Antibiotics versus Appendectomy for Acute Appendicitis: A Randomized Trial

Rupsha Nura Laila, Md Abdul Momen, Md Anayet Ullah, Md Habibullah Sarkar and M Mizanur Rahman

Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh
Department of Community Medicine, Barindo Medical College, Rajshahi, Bangladesh
Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh

^*Correspondance to: M Mizanur Rahman 

 PDF  Full Text DOI: 10.25107/2474-1647.1659

Abstract

Background: Although appendectomy is the standard treatment of Acute Appendicitis (AA), we tried to determine the role of antibiotics in the management of AA and to justify if appendectomy still remains the gold standard of care.Methods: Randomly selected two hundred consecutive suspected AA patients, screened by Modified Alvarado Score, allocated equally in study group (with antibiotics) and control (appendectomy) group. All Pre-, per- and post-treatment clinical information’s collected and recorded in a predesigned data collection sheet and Telephone (or email) follow-ups conducted at 15 days, 1 month, 6 months, and 12 months.Results: Antibiotics were efficacious in 67% of cases, 9 needed urgent appendectomy and 24 relapse cases at 12 months follow-up. Early postoperative complications was 25% in appendectomy group and during follow up 5% present with sub-acute intestinal obstruction.Conclusion: Recurrent appendicitis and risk of missing serious pathology is potential drawback, but good patient selection can help overcome this and Use of antibiotics for the treatment of acute appendicitis could be a good option for treatment.

Keywords

Acute appendicitis; Antibiotic treatment; Recurrent appendicitis; Follow up; Appendectomy; Efficacy; Complications

Cite the article

Laila RN, Md Abdul Momen, Md Anayet Ullah, Md Habibullah Sarkar, Rahman MM. Antibiotics versus Appendectomy for Acute Appendicitis: A Randomized Trial. Clin Surg. 2017; 2: 1659.