Evidence for an Antibiotics-First Strategy for Uncomplicated Appendicitis in Adults: A Systematic Review and Gap Analysis (original) (raw)

2016, Journal of the American College of Surgeons

For more than 120 years, prompt appendectomy has been the standard approach for the treatment of acute appendicitis. 1-3 With >300,000 diagnoses of appendicitis annually, appendectomy is the most commonly performed urgent abdominal operation in the United States. 4,5 Despite the common occurrence of this condition and the relative ease with which appendectomy is performed, both clinicians and the general public question whether we should shift our approach toward nonoperative management of appendicitis. 6,7 Many clinicians in Europe have already adopted this approach; for example, survey data suggest that nearly one-quarter of surgeons in Ireland routinely treat patients with uncomplicated appendicitis nonoperatively. 8

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