Article : Antibiotics Are Not Equal to Appendectomy...

Antibiotics Are Not Equal to Appendectomy for Appendicitis

The incidence of peritonitis at 30 days was higher in the antibiotic group than in the surgery group; 68% of patients treated with antibiotics did not require appendectomy.

Four recent randomized trials suggest that antibiotics alone can cure uncomplicated appendicitis or be used as first-line treatment. In this noninferiority trial, 239 adults with computed tomography–confirmed acute uncomplicated appendicitis at six academic hospitals in France were randomized to receive amoxicillin plus clavulanic acid (3 g daily for 8 to 15 days) or emergent appendectomy.

Incidence of peritonitis at 30 days, the primary endpoint, was significantly higher in the antibiotic group than the surgery group (8% vs. 2%). Overall, 68% of antibiotic-treated patients did not require appendectomy during 1 year of follow-up.


Vons C et al. Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: An open-label, non-inferiority, randomised controlled trial. Lancet 2011 May 7; 377:1573.