Open AccessAntibiotics in acute appendicitis. When and how? A general review
Author(s) -
Lucian Aleçu,
Cornelia Niţipir,
Iulian Slavu,
Vlad Braga,
Daniela Mihăilă,
Adrian Tulin
Publication year - 2019
Publication title -
journal of surgical sciences
Language(s) - English
Resource type - Journals
eISSN - 2457-5364
pISSN - 2360-3038
DOI - 10.33695/jss.v6i1.258
Subject(s) - medicine , antibiotics , perforation , amoxicillin , ertapenem , appendicitis , intensive care medicine , peritonitis , etiology , acute appendicitis , general surgery , ampicillin , surgery , antibiotic resistance , microbiology and biotechnology , biology , materials science , imipenem , metallurgy , punching
An increasing interest exits towards the use of antibiotics in the treatment of uncomplicated acute appendicitis.Discussion: For a long period of time, surgery was the only treatment for acute appendicitis. Due to recent research in the etiology of acute appendicitis which seems to be driven by intraluminal bacterial proliferation, new data suggests that for non-perforated appendicitis confirmed with the help of CT, antibiotics may play a central role in the treatment. As relapse rates amount in some cases to only 5% after antibiotic treament, a discussion is required regarding the risks of interval appendectomy and its use. The debate regarding the optimal antibiotic course is on-going as some surgeons advocate for amoxicillin/clavulanic while others, due to acquired resistance recommend Ertapenem.Conclusion: Selective antibiotic treatment for selected forms of acute appendicitis, uncomplicated without perforation is safe and has a relatively low complication rate. However, certain mentions must be made: surgery must not be delayed if failure of antibiotics exists as it can lead to higher rates of peritonitis. Close clinical surveillance is of utmost importance