Antibiotics for appendicitis! Not so fast.

Introduction: Emerging literature in acute appendicitis favors the non-operative management of acute appendicitis. However, the actual use of this practice on a national level is not assessed. The aim of this study was to assess the changing trends in non-operative management of acute appendicitis and its effects on patient outcomes. Methods: We did an 8-year (2004-2011) retrospective analysis of National Inpatient Sample (NIS) database. We included all in-patients with the diagnosis of acute appendicitis. Patients diagnosed with appendiceal abscess or patients who underwent surgery for any other pathology were excluded from the analysis. Jonckheere-Terpstra trend analysis was performed for operative vs. non-operative management and outcomes. Results: A total of 436,400 cases of acute appendicitis were identified. Mean age of the population was 33+/-19.5 years and 54.5% were male. There was no significant change in the number of acute appendicitis diagnosed over the study period (p=0.2). During the study period non-operative management of acute appendicitis increased significantly from 4.5% in 2004 to 6% in 2011 (p

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