[Treatment with antibiotics for uncomplicated acute appendicitis: strategy and its value]

To establish the characteristics of uncomplicated acute appendicitis (UAA) and assess the efficacy of antibiotics by comparison with emergency appendicectomy for treatment.

A retrospective clinical analysis was made on 742 cases of acute appendicitis. Several characteristics of UAA were identified. Following these rules 46 UAA patients were enrolled to receive antibiotic treatment for at least 48 h.follow-up was carried out for 6 months.

Statistical analysis indicated that high level white blood cell count (>20×10(9)/L,P=0.000, OR=2.717), local or diffuse muscle guarding (P=0.031, OR=1.649), intraluminal stercolith (P=0.000, OR=2.939) and periappendiceal fluid (P=0.005, OR=3.273) were independent risk factors of complicated acute appendicitis. With none of these factors we enrolled 46 UAA patients. Of the 46 patients, 44(95.65%) were treated successfully with antibiotics. 2(4.35%) patients were unexpectedly identified to have complicated appendicitis at surgery. Recurrent appendicitis occurred in 5(11.36%) patients after 6 months. There was no difference in duration of pain and duration of hospital stay between antibiotic treatment group and appendicectomy group.

Although antibiotic treatment may fail in some UAA cases, and there is a risk of recurrence, antibiotic treatment still appears to be a safe first-line therapy for UAA patients.