Comparison of Antibiotic treatment and Appendectomy for non-complicated Acute Appendicitis during Covid-19 pandemic
M. Waseem Anwar, M. Faheem Anwer, Wasif Majeed Chaudhry, Farhana Anwar, M. Usman Aslam, Rashid Usman, Fizza Anwar
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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.