Comparison of Antibiotic treatment and Appendectomy for non-complicated Acute Appendicitis during Covid-19 pandemic

Abstract

Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated acute appendicitis in pandemic situation. Study Design: Prospective interventional study. Setting & Duration of Study: CMH Lahore, a 700 bedded tertiary care hospital, for 4 months from 15th April 2020 to 15th august 2020. Methodology: A total of 110 cases meeting inclusion criteria, aged 13-65 years of both genders with suspicion of non-complicated appendicitis were included in the study, using probability sampling. They were divided in two groups on randomization basis. Group A for antibiotic therapy and Group B for appendectomy. Group A patients admitted in the ward 48 hours for IV antibiotics, were re-evaluated after 24 hours. If condition improves, the patient was discharged on oral antibiotics for next 10 days & if condition does not improve, antibiotics were prolonged for 48 hours. If deteriorating or patient. .chooses to change group, they underwent appendectomy. If condition improved, they were discharged on oral antibiotics for next 10 days. Group B patient were discharged after 2 post-operative doses of I/V antibiotics. Post-operative I/V antibiotics for 48 hours & 3 days oral antibiotics were given when appendix was gangrenous or perforated. Results: In a population of 110 patients, we studied the comparison of the groups having antibiotics and appendectomy as treatment for acute appendicitis. There is no significant difference in outcomes on basis of mean pain score and mean duration of hospital stay. Both ways of treatment can be adapted accordingly. Conclusion: Non-complicated acute appendicitis can be managed non-operatively in crisis situations like COVID-19 pandemic causing overburdening of hospitals. Keywords: Acute appendicitis, antibiotic therapy, appendectomy, pandemic.