Antibiotic Treatment of Uncomplicated Acute-appendicitis in Children

Objective: To evaluate the safety and outcome of antibiotic treatment of uncomplicated acute appendicitis in children. Our main outcomes were the response to conservative treatment, complications during this treatment and short-term recurrence of appendicitis in initial responders to treatment.

Methods: We used antibiotics instead of surgery to treat 70 children aged 4-18 years who were diagnosed with acute uncomplicated appendicitis (AUA). Those not responding or who show deterioration were shifted to appendectomy. We followed up our cases who had successful NOM for any relapse at one week, 6 weeks, 3months then 6months.

Results: The success rate of NOM in our series was 84.3%. Most cases showed improvement of both clinical & laboratory findings on 2nd day of management. Eleven cases (15.7 %) failed NOM and were operated laparoscopically. Readmission for cases who had a relapse occurred in 3 cases, one case relapsed after 6 weeks of discharge, and was operated by laparoscopy. Another 2 cases were readmitted with after 3 months. They were managed conservatively again, and responded to NOM.

Conclusion: Using antibiotic management of AUA among children aged 4-18 years, proved to be safe, effective and have a low rate of complications. It reduced the negative appendectomy rate to 1.43%. It is associated with a low relapse rate within 6 months and significantly reduces the treatment cost.