Appendicitis is one of the most common diseases general surgeons treat. Surgical appendectomy has been the mainstay of treatment for appendicitis for more than a century, predating antibiotic therapy. The antibiotics-first movement is gaining momentum based primarily on European trials and papers. Systematic reviews and meta-analyses1 have yet to reach a conclusive answer, prompting further investigation. Salminen and colleagues2 presented another randomized clinical trial attempting to answer whether antibiotics or surgery is the preferred treatment for simple, uncomplicated acute appendicitis. Unfortunately, their work will not change my opinion about management of acute appendicitis.
Haut ER. Results of Yet Another Antibiotics vs Appendectomy Randomized TrialStill Not Enough to Change My Practice. JAMA Surg. 2016;151(2):191-192. doi:10.1001/jamasurg.2015.4218