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February 2016

Antibiotics vs Surgery for Acute Appendicitis: Toward a Patient-Centered Treatment Approach

Author Affiliations
  • 1University of Michigan Medical School, Ann Arbor
  • 2Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
  • 3Center for Healthcare Outcomes and Policy, Department of Surgery, University of Michigan Medical School, Ann Arbor
JAMA Surg. 2016;151(2):107-108. doi:10.1001/jamasurg.2015.4065

The publication of the Appendicitis Acuta (APPAC) trial in JAMA by Salminen et al1 generated significant debate about the best way to treat this common disease. This high profile study challenged more than 100 years of practice, attracted extensive media coverage, and sparked animated debate among physicians about the safety and efficacy of antibiotics therapy for treatment of uncomplicated appendicitis. This Viewpoint reviews the study results, outlines both sides of an ongoing debate, and provides recommendations for surgeons who will be confronted by patients questioning whether they need surgery.