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Although many patients were safely managed with antibiotics during covid-19, Abdullah K Malik and colleagues argue that the associated risks and patient burden make surgery the best approach for appendicitis Acute appendicitis is a common condition that almost all doctors will encounter at some point during their career. Until recently patients were usually treated surgically with an appendicectomy, with antibiotics used for those with prohibitively high perioperative risks because of comorbidities or an appendiceal mass. However, conservative management of acute appendicitis was advocated during the covid-19 pandemic because of concerns about aerosol formation during laparoscopic surgery and higher risk of morbidity and mortality in patients with covid-19.12 Further evidence has accumulated on the safety and effectiveness of antibiotics in adults with acute appendicitis.345678 This, together with greater use of computed tomography to identify complications, has shifted attitudes and

Lomalan reddyAlexanderw phillipsAbdullahk malikClara munroAilsah innes