SynthesisInternational journal of colorectal disease2019
Antibiotic therapy for acute uncomplicated appendicitis: a systematic review and meta-analysis.
Synthesis in International journal of colorectal disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 5 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Comparison of the efficacy and safety of antibiotic treatment and appendectomy for acute uncomplicated appendicitis: a systematic review and meta-analysis.BMC surgery · 2023Pooled it
- Nonoperative vs Operative Management of Uncomplicated Acute Appendicitis: A Systematic Review and Meta-analysis.JAMA surgery · 2022Pooled it
- Efficacy and Safety of Non-Operative Management of Uncomplicated Acute Appendicitis Compared to Appendectomy: An Umbrella Review of Systematic Reviews and Meta-Analyses.World journal of surgery · 2022Pooled it
- Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Pooled it
- Acute Appendicitis in Childhood and Adulthood.Deutsches Arzteblatt international · 2020Pooled it
- Inflammatory phenotyping by latent class analysis and machine learning-based prediction of postoperative complications in pediatric appendicitis: a retrospective cohort study.Frontiers in medicine · 2026Article
- Indication of conservative treatment by antibiotics for uncomplicated and complicated acute appendicitis.World journal of gastrointestinal surgery · 2024Article
- Retrospective analysis of the incidence of appendiceal neoplasm and malignancy in patients treated for suspected acute appendicitis.BMC surgery · 2024Article
- Colonoscopy in the diagnosis and management of appendiceal disease.World journal of gastrointestinal endoscopy · 2024Article
- Review
- Acute Appendicitis Treatment Strategies and Mortality Based on Critical Illness on Admission: An Observational Study.Surgical infections · 2024Observational
- Review
- Periappendiceal fluid collection on preoperative computed tomography can be an indication for interval appendectomy: a retrospective study.World journal of emergency surgery : WJES · 2022Article
- The appendix-mucosal immunity and tolerance in the gut: consequences for the syndromes of appendicitis and its epidemiology.ANZ journal of surgery · 2022Article
- Antibiotics as first-line alternative to appendicectomy in adult appendicitis: 90-day follow-up from a prospective, multicentre cohort study.The British journal of surgery · 2021Observational
- Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study.World journal of emergency surgery : WJES · 2021Article
- Conservative management of acute appendicitis in the era of COVID 19: A multicenter prospective observational study at the United Arab Emirates.International journal of surgery open · 2021Article
- Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem.Geriatrics (Basel, Switzerland) · 2021Review
- Adapting an emergency general surgery service in response to the COVID-19 pandemic.Annals of the Royal College of Surgeons of England · 2021Article
- Clinical Outcomes of Acute Appendicitis During Pregnancy: Conservative Management and Appendectomy.World journal of surgery · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAppendectomy 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.
methodsIn 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.
resultsFive 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).
conclusionsThis 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.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.