Eligible studies were RCTs that compared antibiotic treatment versus appendicectomy for uncomplicated acute appendicitis in adults. The primary outcome was complications relevant to the condition (such as wound infection, incidence of perforated appendicitis or peritonitis). The main secondary outcomes were length of hospital stay, readmissions, and treatment efficacy. Eligible trials had to include at least two of the pre-specified outcomes. Non-randomised studies, retrospective studies, case series, and studies reporting outcomes for patients with complicated appendicitis were excluded.
In included trials, the mean age of patients ranged from 27 to 38 years (where reported). Diagnosed or suspected uncomplicated acute appendicitis was indicated via computed tomography, ultrasonography, gynaecological examination, laboratory tests, clinical signs (not stated), positive history, increased white blood cell counts, and high C reactive protein levels. Antibiotics administered were amoxicillin plus clavulanic acid, cefotaxime, ciprofloxacin, metronidazole, ofloxacin, and tinidazole. Doses and regimens varied, including antibiotics administered postoperatively. Most surgery was conducted using open or laparoscopic techniques.
Two reviewers independently selected studies for inclusion; discrepancies were resolved by discussion with a third reviewer.