A 10-day course of antibiotics is as effective against appendicitis as traditional surgery, although less effective in patients with appendicolith, according to a new US trial.

With 1552 randomised participants treated at 25 medical centers, the study is the largest appendicitis trial ever conducted.

At 30 days, quality-of-life scores were essentially identical whether a volunteer was placed in the antibiotics or appendectomy group, while patients in the antibiotic group missed less time at work and school.

When antibiotics were given, 29% of the patients ended up receiving surgery within 90 days anyway.