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Viewpoint |

Antibiotics vs Surgery for Acute Appendicitis Toward a Patient-Centered Treatment Approach

Steven J. Hasday, BS1; Karan R. Chhabra, AB2; Justin B. Dimick, MD, MPH3
[+] Author Affiliations
1University of Michigan Medical School, Ann Arbor
2Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
3Center for Healthcare Outcomes and Policy, Department of Surgery, University of Michigan Medical School, Ann Arbor
JAMA Surg. 2016;151(2):107-108. doi:10.1001/jamasurg.2015.4065.
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This Viewpoint reviews the study results of and reactions to the Salminen et al acute appendicitis trial and provides recommendations for surgeons who will be confronted by patients questioning whether they need surgery.

The publication of the Appendicitis Acuta (APPAC) trial in JAMA by Salminen et al1 generated significant debate about the best way to treat this common disease. This high profile study challenged more than 100 years of practice, attracted extensive media coverage, and sparked animated debate among physicians about the safety and efficacy of antibiotics therapy for treatment of uncomplicated appendicitis. This Viewpoint reviews the study results, outlines both sides of an ongoing debate, and provides recommendations for surgeons who will be confronted by patients questioning whether they need surgery.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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