Antibioticoterapia versus apendicectomía en apendicitis aguda no complicada en adultos y niños: revisión sistemática

Abstract

Traditionally, acute appendicitis has been treated through open surgery; however, laparoscopic surgery has become the most widely used method today. Additionally, the use of antibiotics is being evaluated, specifically in uncomplicated cases. Objective: To evaluate the comparative effectiveness of antibiotic therapy versus appendectomy in the treatment of uncomplicated acute appendicitis in adults and children. Methodology: Twenty studies comparing the use of antibiotics and appendectomy for the treatment of uncomplicated acute appendicitis in children and adults were analyzed using search engines and electronic databases such as Scopus, Taylor & Francis, Web of Science, UpToDate, DynaMed Plus, and PubMed. Results were synthesized into tables, and bias was assessed using various scales. Results: The quality of life in adults was significantly improved with broad-spectrum antibiotics like metronidazole, with scores above 0.86 points. Only one study reported elevated scores in children. Recurrence rates of acute appendicitis ranged from 11% to 33.5% in adults and from 3% to 45.8% in children. Conclusions: The combination of ciprofloxacin and metronidazole was the most commonly used antibiotic regimen, with success rates ranging from 64% to 98.46%. Hospital stays for antibiotic treatment ranged from 28.9 hours to 6.8 days, while stays for the surgical group ranged from 1 to 4 days, with a maximum period of 3 days in children. Keywords: appendicitis, adult, child, antibiotics, quality of life