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World J Surg (2012) 36:2028–2036
DOI 10.1007/s00268-012-1641-x
Antibiotics as First-line Therapy for Acute Appendicitis: Evidence
for a Change in Clinical Practice
• • •
¨
Jeanette Hansson Ulla Korner Karin Ludwigs
• •
¨
Erik Johnsson Claes Jonsson Kent Lundholm
Published online: 9 May 2012
´ ´
Societe Internationale de Chirurgie 2012
Abstract Conclusions This population-based study confirms pre-
Background Randomized studies have indicated that vious results of randomized studies. Antibiotic treatment
acute appendicitis may be treated by antibiotics without the can be offered as the first-line therapy to a majority of
need of surgery. However, concerns have been raised about unselected patients with acute appendicitis without medical
selection bias of patients in such studies. Therefore, the drawbacks other than the unknown risk for long-term
present study was aimed to validate previous findings in relapse, which must be weighed against the unpredicted but
randomized studies by a full-scale population-based well-known risk for serious major complications following
application. surgical intervention.
Methods All patients with acute appendicitis at
Sahlgrenska University Hospital (May 2009 and February
2010) were offered intravenous piperacillin plus tazobac- Introduction
tam according to our previous experience, followed by
9 days out-hospital oral ciprofloxa
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