Surgery or antibiotics for appendicitis?

I felt embarrassed! The surgical registrar and I both looked at my son’s scaphoid abdomen with an obvious appendix mass in the right iliac fossa. I had sent him to school a few days ago with his abdominal pain. We discussed the merits of antibiotics vs surgery and that interval appendectomy was no longer recommended. I presume my son still has the remnants of his appendix; he certainly has vivid memories of how his father neglected him. What about antibiotics for patients presenting with acute appendicitis? It is always worthwhile looking at the adult literature. This study by the CODA Collaborative (Comparison of Outcomes of Antibiotic Drugs and Appendectomy) [NEJM 2020 DOI: 10.1056/NEJMoa2014320] set out to examine exactly that. The literature is full of underpowered and non-generalisable studies in both the paediatric and adult world. This was a pragmatic, non-blinded, non-inferiority, randomised trial comparing antibiotic therapy (10 day course) with...

from Archives of Disease in Childhood current issue https://ift.tt/3pQGBTm