- Title
- The efficacy of antibiotic treatment versus surgical treatment of uncomplicated acute appendicitis: systematic review and network meta-analysis of randomized controlled trial
- Creator
- Poprom, Napaphat; Numthavaj, Pawin; Wilasrusmee, Chumpon; Rattanasiri, Sasivimol; Attia, John; McEvoy, Mark; Thakkinstian, Ammarin
- Relation
- American Journal of Surgery Vol. 218, Issue 1, p. 192-200
- Publisher Link
- http://dx.doi.org/10.1016/j.amjsurg.2018.10.009
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2019
- Description
- Background: The efficacy of antibiotics in appendicitis remains controversial, and physicians are not confident in prescribing antibiotics as the first line treatment. This network meta-analysis was conducted to assess the efficacy and safety of individual antibiotics in uncomplicated appendicitis. Methods: Randomized controlled trials (RCTs) were identified from MEDLINE and SCOPUS databases since inception to July 2017. Studies. Network meta-analysis was applied to estimate treatment effects and safety. Probability of being the best treatment was estimated using surface under the cumulative ranking curve (SUCRA). Results: Among 9 RCTs meeting our inclusion criteria. A network meta-analysis indicated that those receiving antibiotics had about 12-32% lower chance of treatment success and lower risk of complication about 23-86%, especially Beta-lactamase than appendectomy. The overall appendicitis recurrence rate in the antibiotic group was about 18.2%. The SUCRA indicated that appendectomy was ranked first for treatment success and least complications, followed by Beta-lactamase. Conclusions: Appendectomy is still the most effective treatment in uncomplicated appendicitis but it carries complications. Beta-lactamase, might be an alternative treatment if there are any contraindications for operation.
- Subject
- antibiotics treatment; uncomplicated appendicitis; network meta-analysis
- Identifier
- http://hdl.handle.net/1959.13/1467546
- Identifier
- uon:47841
- Identifier
- ISSN:0002-9610
- Language
- eng
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