Napaphat PopromPawin NumthavajChumpon WilasrusmeeSasivimol RattanasiriJohn AttiaMark McEvoyAmmarin ThakkinstianUniversity of Newcastle, Faculty of Health and MedicineFaculty of Medicine, Ramathibodi Hospital, Mahidol University2020-01-272020-01-272019-07-01American Journal of Surgery. Vol.218, No.1 (2019), 192-20018791883000296102-s2.0-85054847527https://repository.li.mahidol.ac.th/handle/20.500.14594/51571© 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.Mahidol UniversityMedicineReviewSCOPUS10.1016/j.amjsurg.2018.10.009