Antibiotic treatment for appendicitis in Norway and Sweden : a nationwide survey on treatment practices

• Published in: BMC Surgery
• Main Authors: Gran, M. V., KjønÃ¥s, D., Gunnarsson, Ulf, StrigÃ¥rd, Karin, Revhaug, Arthur, Aahlin, E. K.
• Format: Article in Journal/Newspaper
• Language: English
• Published: UmeÃ¥ universitet, Kirurgi 2022
• Subjects: Anti-bacterial agents; Appendectomy; Appendicitis; Conservative treatment; Surgery; Surveys and questionnaires; Public Health; Global Health; Social Medicine and Epidemiology; Folkhälsovetenskap; global hälsa; socialmedicin och epidemiologi; North Norway; Arctic University of Norway
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-197703; https://doi.org/10.1186/s12893-022-01680-2

BACKGROUND: Appendicitis is one of the most common causes of acute abdomen. Uncomplicated appendicitis is as an inflamed appendix without perforation, gangrene or abscess formation. Recent trials show that one can safely treat uncomplicated appendicitis with antibiotics, given patient approval and appropriate follow-up. A recent study has also indicated no difference between antibiotic treatment and placebo. Our aim was to investigate if Norwegian and Swedish surgical departments treat uncomplicated appendicitis with antibiotics and to explore their opinions on this treatment practice. METHODS: A questionnaire was distributed to all heads of department in hospitals that treat appendicitis in Norway and Sweden. Answers were collected using a REDCap survey. Answers were compared between centers and nations and the results were presented anonymously. RESULTS: We sent the questionnaire to 94 eligible recipients and received 61 (65%) answers. In total, 8/61 (13%) departments stated that they have established antibiotic treatment as sole treatment for uncomplicated appendicitis. Almost half of the responders stated that they have used antibiotics sporadically to treat uncomplicated appendicitis. Lack of evidence and guidelines were noted as reasons why antibiotic treatment has not been implemented as sole treatment. CONCLUSIONS: Most Norwegian and Swedish departments have not implemented antibiotic treatment as the sole treatment for uncomplicated appendicitis. Despite several recent large trials on this subject, lack of evidence and guidelines was the most frequently reported reason in our survey. Open access funding provided by UiT The Arctic University of Norway (incl University Hospital of North Norway). The authors received no financial support for the research and/or authorship of this article.