To determine the frequency of operations in acute appendicitis after antibiotic therapy.

Abstract

A descriptive, cross sectional study conducted to evaluate the results of conservative management of acute appendicitis with antibiotic therapy. Study Design: Descriptive, cross sectional study. Setting: Surgical Unit of Aziz Fatima Trust Hospital. Period: 1^st Jan 2017 to 31^st December 2018.  Materials and Methods:  The objective of this study is to determine the frequency of operations in acute appendicitis being treated by antibiotic therapy. A total of 140 patients were included in this study. Study patients having a modified Alvarado score of 7-9 received intravenous antibiotics (ciprofloxacin 400mg twice and metronidazole 500 mg thrice) for at least 24 hours. Patients’ whose status were improved as monitored by an improved modified Alvarado score and a decreased serial C reactive Protein measurement on the following morning, were discharged to continue with oral antibiotics. In patients whose clinical condition had not improved, intravenous treatment was prolonged for 48 hours and in case of deterioration in clinical condition, they were subjected to appendicectomy. Results: Mean age of the patients was 25.41±7.28 years. Out of 140 patients, 51 (36.4%) were male while remaining 89 patients (63.6%) were female. Regarding Alvarado score, 53 patients (37.9%) had 7 score, 60 patients (42.9%) had 8 score and 27 patients (19.6%) had 9 score. Mean Alvarado score was observed 7.81±0.73. Operation was needed in 13 patients (9.3%). Conclusion: In conclusion, acute appendicitis can be treated successfully with antibiotics. However, there is a risk of recurrence in cases of acute appendicitis, and this risk should be compared with the risk of complications after appendectomy.