Skip to main content
main-content

19.04.2019 | Review | Ausgabe 6/2019

International Journal of Colorectal Disease 6/2019

Antibiotic therapy for acute uncomplicated appendicitis: a systematic review and meta-analysis

Zeitschrift:
International Journal of Colorectal Disease > Ausgabe 6/2019
Autoren:
Daniela Prechal, Fuad Damirov, Maurizio Grilli, Ulrich Ronellenfitsch
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00384-019-03296-0) contains supplementary material, which is available to authorized users.

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

Appendectomy has been the gold standard for every form of appendicitis. In recent years, though, it has repeatedly been claimed that for acute uncomplicated appendicitis, antibiotic therapy can be an equivalent treatment. The aim of this meta-analysis was to determine if antibiotic therapy is a safe and effective alternative to appendectomy for acute uncomplicated appendicitis.

Methods

In a systematic literature review, relevant databases were searched for randomized studies comparing appendectomy with antibiotic treatment for uncomplicated acute appendicitis. Two independent reviewers performed study selection and data extraction. The primary endpoint was the successful treatment of appendicitis. Secondary endpoints were pain intensity, duration of hospitalization, absence from work, and the incidence of complications.

Results

Five randomized controlled studies (n = 1430 patients) fulfilled the inclusion criteria. Of the 727 patients treated initially with antibiotics, 272 (37.4%) underwent secondary appendectomy within 1 year (treatment effectiveness: 62.6% compared to 96.3% in the surgical group, RR 0.65, 95% CI 0.55–0.76, p < 0.00001). Neither duration of hospital stay (MD 0.11 days, 95% CI: − 0.22–0.43, p = 0.53) nor the probability of complication-free treatment (RR 1.08, 95% CI: 0.97–1.22, p = 0.16) were significantly different between the two treatments. Absence from work was significantly shorter in the antibiotic group (MD − 2.49 days, 95% CI: − 4.59–− 0.40, p = 0.02).

Conclusions

This meta-analysis shows that appendectomy is more effective than antibiotic therapy for definitive cure of acute uncomplicated appendicitis. However, since the incidence of complications does not differ between the two treatments, antibiotic therapy might be a reasonable alternative for selected patients.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Jetzt e.Med bestellen und 100 € sparen!

Weitere Produktempfehlungen anzeigen
Zusatzmaterial
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 6/2019

International Journal of Colorectal Disease 6/2019 Zur Ausgabe
  1. Sie können e.Med Innere Medizin 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

  2. Sie können e.Med Chirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise