title: Antibiotics versus appendectomy in the management of acute appendicitis: a review of the current evidence.
abstract: BACKGROUND
  Acute appendicitis remains the most common cause of the acute abdomen in young adults, and the mainstay of treatment in most centres is an appendectomy. However, treatment for other intra-abdominal inflammatory processes, such as diverticulitis, consists initially of conservative management with antibiotics. The aim of this study was to determine the role of antibiotics in the management of acute appendicitis and to assess if appendectomy remains the gold standard of care.
  
  
  METHODS
  A literature search using MEDLINE and the Cochrane Library identified studies published between 1999 and 2009, and we reviewed all relevant articles. The articles were critiqued using the Public Health Resource Unit (2006) appraisal tools.
  
  
  RESULTS
  Our search yielded 41 papers, and we identified a total of 13 papers within the criteria specified. All of these papers, while posing pertinent questions and demonstrating the role of antibiotics as a bridge to surgery, failed to adequately justify their findings that antibiotics could be used as a definitive treatment of acute appendicitis.
  
  
  CONCLUSIONS
  Appendectomy remains the gold standard of treatment for acute appendicitis based on the current evidence.
authors.affiliation: Department of General Surgery, Craigavon Area Hospital, Portadown, Northern Ireland. gfitzmaurice@doctors.org.uk
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Fitzmaurice
authors.forename: Billy
authors.initials: B
authors.lastname: McWilliams
authors.forename: Hisham
authors.initials: H
authors.lastname: Hurreiz
authors.forename: Emanuel
authors.initials: E
authors.lastname: Epanomeritakis
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001062:Appendectomy; D001064:Appendicitis / Q000628:therapy*; D003657:Decision Making; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents