Appendicectomy for suspected uncomplicated appendicitis is associated with fewer complications than conservative antibiotic management: A meta-analysis of post-intervention complications. Issue 2 (February 2015)

• Record Type: Journal Article
• Authors: Kirby, Andrew; Hobson, Richard P.; Burke, Dermot; Cleveland, Victoria; Ford, Georgia; West, Robert M.
• Is Part Of: Journal of infection. Volume 70:Issue 2(2015)
• Page Start: 105
• Page End: 110
• Publication Date: 2015-02
• Subjects: Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2014.08.009
• Languages: English
• ISSNs: 0163-4453

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Objectives</title> <p id="abspara0010">Recent literature has concluded antibiotic therapy results in fewer complications than appendicectomy for patients with uncomplicated appendicitis. This studies aim was to undertake a meta-analysis of major post-intervention outcomes in patients with suspected uncomplicated appendicitis treated with antibiotics or appendicectomy, and determine which treatment is associated with the lowest rate of major complications.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">We analysed randomised trials of antibiotics vs. appendicectomy in adults with suspected uncomplicated appendicitis. The primary outcome measure was a composite of major complications, peritonitis and intra-abdominal abscess, occurring after appendicectomy or initiation of therapeutic antibiotics.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">The rate of major post-intervention complications was 0.8% (2/263) in the appendicectomy group and 10.1% (27/268) in the antibiotic group. This difference was statistically significant by the random effects model: Risk Ratio 7.71, 95% C.I. 2.33 to 25.53, Risk Difference 0.09: 95% C.I. 0.05 to 0.13. The Number Needed to Harm (NNH) from antibiotic therapy is 10.7.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">Suspected uncomplicated appendicitis has a lower rate of major post-intervention complications when managed with primary appendicectomy compared to antibiotic therapy.</p> </sec> </abstract>