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Review
. 2018 Jul 11;18(4):e7228.
doi: 10.5867/medwave.2018.04.7229.

Are antibiotics a safe and effective treatment for acute uncomplicated appendicitis?- First update

[Article in Spanish, English]
Rubén Allende  1 , Rodrigo Muñoz  2
Affiliations
Review

Are antibiotics a safe and effective treatment for acute uncomplicated appendicitis?- First update

[Article in Spanish, English]
Rubén Allende et al. Medwave. .

Abstract
in English, Spanish

Update: This Living FRISBEE (Living FRIendly Summary of the Body of Evidence using Epistemonikos) is an update of the summary published in January 2016.

Introduction: Appendicitis is a typical cause of acute abdominal pain and the most frequent cause of emergency abdominal surgery. In the last two decades, increasing evidence has been published about the use of antibiotics as an exclusive treatment for acute appendicitis.

Methods: To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained through searches from multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted the data from the identified reviews, reanalyzed the data from the primary studies, performed a meta-analysis and prepared a summary of findings table using the GRADE approach.

Results and conclusions: We identified 23 systematic reviews including 28 primary studies, of which eight were randomized trials. We concluded the exclusive use of antibiotics for the treatment of uncomplicated acute appendicitis could be less effective than appendectomy, but it might be associated with a lower rate of complications.

Actualización: Este resumen Epistemonikos (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos) es una actualización del resumen publicado en enero de 2016.

Introducción: La apendicitis es una causa típica de dolor abdominal agudo y la causa más frecuente de cirugía abdominal de urgencia. En las últimas dos décadas se ha publicado creciente evidencia sobre el uso de antibióticos como tratamiento exclusivo de la apendicitis aguda.

Métodos: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE.

Resultados y conclusiones: Identificamos 23 revisiones sistemáticas que en conjunto incluyeron 28 estudios primarios, de los cuales ocho corresponden a ensayos aleatorizados. Concluimos que el uso exclusivo de antibióticos para el tratamiento de la apendicitis aguda no complicada podría ser menos efectivo que la apendicectomía y asociarse a una mayor estadía hospitalaria, pero por otro lado podría asociarse a una menor tasa de complicaciones.

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    Kumar SS, Collings AT, Lamm R, Haskins IN, Scholz S, Nepal P, Train AT, Athanasiadis DI, Pucher PH, Bradley JF 3rd, Hanna NM, Quinteros F, Narula N, Slater BJ. Kumar SS, et al. Surg Endosc. 2024 Jun;38(6):2974-2994. doi: 10.1007/s00464-024-10813-y. Epub 2024 May 13. Surg Endosc. 2024. PMID: 38740595

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