Rupsha Nura Laila1, Md Abdul Momen1, Md Anayet Ullah2, Md Habibullah Sarkar1 and M Mizanur Rahman3*
1Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh
2Department of Community Medicine, Barindo Medical College, Rajshahi, Bangladesh
3Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh
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.
Acute appendicitis; Antibiotic treatment; Recurrent appendicitis; Follow up; Appendectomy; Efficacy; Complications
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.