Evaluating the Effectiveness and Safety of Different Antibiotic Regimen used in the Treatment of Acute Appendicitis

Acute appendicitis (AA) remains one of the most common causes for emergency abdominal surgery worldwide, though recent evidence supports non-operative management of uncomplicated cases with intravenous (IV) antibiotics, particularly in resource-limited settings or during global health crises like COVID-19. This prospective observational study included 50 clinically and radiologically diagnosed patients with uncomplicated AA who were treated conservatively with IV antibiotics, either Ciprofloxacin + Metronidazole or Piperacillin + Tazobactam. Data on demographics, imaging (USG/CT), Alvarado score, comorbidities, clinical response, and outcomes were collected and analyzed. Results showed that 72% of patients were cured with antibiotics, 12% experienced partial relief, 6% showed no change, 4% worsened, and 6% eventually required surgery, with complications being minimal and mostly gastrointestinal. Statistical analysis revealed no significant correlation between specific antibiotic regimens and outcomes (p = 0.73), though higher Alvarado scores were positively associated with improved outcomes (p = 0.039). In conclusion, conservative management with IV antibiotics is a safe and effective alternative to surgery in carefully selected patients with uncomplicated AA, with clinical scoring and imaging playing a vital role in patient selection and monitoring.