Efficacy and quality of life of Antibiotic-only treatment of
Conservative management with antibiotics only has emerged as a potential treatment option for acute uncomplicated appendicitis. But according to this research by Annals of Surgery, surgery should remain the mainstay of treatment.

The study evaluates the efficacy and quality of life associated with conservative treatment of acute uncomplicated appendicitis.

Symptomatic patients with radiological evidence of acute, uncomplicated appendicitis were randomized to either intravenous antibiotics only or undergo appendectomy. One hundred eighty-six patients underwent randomization.

- In the antibiotic-only group, 23 patients experienced a recurrence within 1 year following randomization.

- There was a significantly better EQ-VAS quality of life score in the surgery group compared with the antibiotic-only group at 3 months and 12 months post-intervention. The EQ-5D-3L quality-of-life score was significantly higher in the surgery group indicating a better quality of life.

- The accumulated 12-month sickness days were 3.6 days shorter for the antibiotics-only group.

- The mean length of stay in both groups was not significantly different. The mean total cost in the surgery group was significantly higher than in the antibiotics-only group.

Conclusively, patients with acute, uncomplicated appendicitis treated with antibiotics only experience high recurrence rates and inferior quality of life. Surgery should remain the mainstay of treatment for this commonly encountered acute surgical condition.

Source: https://journals.lww.com/annalsofsurgery/Abstract/2021/08000/A_Randomized_Clinical_Trial_Evaluating_the.11.aspx