Publication: The efficacy of antibiotic treatment versus surgical treatment of uncomplicated acute appendicitis: Systematic review and network meta-analysis of randomized controlled trial
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Issued Date
2019-07-01
Resource Type
ISSN
18791883
00029610
00029610
Other identifier(s)
2-s2.0-85054847527
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Surgery. Vol.218, No.1 (2019), 192-200
Suggested Citation
Napaphat Poprom, Pawin Numthavaj, Chumpon Wilasrusmee, Sasivimol Rattanasiri, John Attia, Mark McEvoy, Ammarin Thakkinstian The efficacy of antibiotic treatment versus surgical treatment of uncomplicated acute appendicitis: Systematic review and network meta-analysis of randomized controlled trial. American Journal of Surgery. Vol.218, No.1 (2019), 192-200. doi:10.1016/j.amjsurg.2018.10.009 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/51571
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Title
The efficacy of antibiotic treatment versus surgical treatment of uncomplicated acute appendicitis: Systematic review and network meta-analysis of randomized controlled trial
Abstract
© 2018 The Authors 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.