Amar Hegde¹, Anand Bhandary Panambur²* and Ashok Hegde³

¹Resident, A.J. Institute of Medical Centre and Research Centre, Mangalore, India
²Assistant Professor, A.J. Institute of Medical Centre and Research Centre, Mangalore, India
³Professor, Department of General Surgery, A.J. Institute of Medical Centre and Research Centre, Mangalore, India

*Corresponding Author:Anand Bhandary Panambur, Assistant Professor, Department of General Surgery, A.J. Institute of Medical Sciences and Research Center, Mangalore, India.

Received: October 25, 2024; Published: December 10, 2025

Abstract

Introduction: The gold standard for treating acute appendicitis is an appendicectomy (Laparoscopic/open). The necessity of sur gery has been questioned lately. The use of antibiotics as a non-operative therapy for acute appendicitis is becoming more and more popular with clinicians and patients. Treatment of appendicitis varies from emergency appendicectomy to non-operative therapy with antibiotics; there is no clear standard protocol for treating this condition. As per few studies, it has been suggested that antibi otic medication be used to treat appendicitis instead of surgery. The best course of action for acute appendicitis is still up for debate. We aimed to evaluate the clinical results of individuals treated with an urgent surgery for acute uncomplicated appendicitis against a trial of nonoperative treatment.

Methods: In order to compare antibiotic treatment (10-day course) with appendicectomy for patients with acute uncomplicated appendicitis at our institute, we undertook a pragmatic, non-blinded, non-inferiority, randomized study. Based on a 30-day health status, the Comparison of Outcomes of Antibiotic Drugs and Appendicectomy (CODA) trial which we used it as protocol in our study indicated that antibiotics were not inferior to appendicectomy. Adult patients (>18yrs) with acute uncomplicated appendicitis with no added comorbidities were included. The non-operative management group and the immediate surgery group's patient characte ristics and results were compared.

Results: For a year, this study was conducted prospectively. 112 patients in all fulfilled our inclusion criteria. 46 of them had a first nonoperative management trial, with an 86.1% success rate. Compared to patients in the urgent surgery group, patients who failed nonoperative therapy needed far longer hospital stays (4 versus 10 days). 56 were given antibiotics (47% of whom not admitted without receiving the index therapy), and 76 had appendix removed (65% of whom underwent a laparoscopic surgery). Based on 30-day EQ-5D scores (European Quality of Life–5 Dimensions (EQ-5D) questionnaire) (mean difference, 0.01 points; 95% confidence interval [CI], −0.001 to 0.03), antibiotics were not inferior to appendicectomy. Among the patients receiving antibiotics, 17% had undergone an appendectomy within the 3 months of availing antibiotics therapy; this included 61% of those with an appendicolith and 39 % of those without an appendicolith. In individuals assigned to receive antibiotic therapy, there were no significant problems linked to delayed appendicectomy, including intra-abdominal abscesses.

Conclusion:For the treatment of appendicitis, antibiotics were non-inferior to appendectomy on the basis of results of a standard health-status measure. Almost 4 out of 10 individuals in the antibiotics group had undergone an appendicectomy by 3 months. Compared to those without an appendicolith, those with an appendicolith had a greater risk of appendicectomy and complications. During the three-month follow-up period, the majority of patients who were randomly assigned to receive antibiotic therapy for un complicated appendicitis did not require an appendectomy, and those who did not have any serious complications.

Keywords: Appendicectomy; Computed Tomography (CT); Acute Appendicitis

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Citation

Citation: Anand Bhandary Panambur., et al. “A Comparison of the Safety and Effectiveness of Appendectomy and Antibiotic Therapy for Acute Uncomplicated Appendicitis - Single Center Institutional Experience". Acta Scientific Clinical Case Reports 6.1 (2025): 08-12.

Copyright

Copyright: © 2025 Anand Bhandary Panambur., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.