{
  "schema_version": 1,
  "kind": "condition",
  "id": "acute-appendicitis",
  "name": "Acute Appendicitis (Emergency Referral)",
  "category": "emergency",
  "sources": "Appendicitis - StatPearls, Lotfollahzadeh, Lopez & Deppen, updated 12 February 2024 - https://www.ncbi.nlm.nih.gov/books/NBK493193/ · No dose - referral pathway, no medicine given in primary care",
  "review_status": "reviewed",
  "verified_against": "Appendicitis - StatPearls, Lotfollahzadeh, Lopez & Deppen, updated 12 February 2024 - https://www.ncbi.nlm.nih.gov/books/NBK493193/ · No dose - referral pathway, no medicine given in primary care",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 29,
      "generic": "No drug therapy in primary care (Recognition & Referral)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "Same-day surgical referral. Pain that begins diffuse or around the umbilicus and then localises to the right lower quadrant is the classic course; fever is present in about 40%. Do NOT give antibiotics and review tomorrow, and do NOT let a normal temperature or a soft abdomen early on reassure you - the appendix can perforate while the patient is still walking. Analgesia does not mask the diagnosis and should not be withheld.",
      "adult_duration": "Refer, with advice",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": null,
      "cautions": [
        "SURGICAL EMERGENCY. StatPearls puts rupture at roughly 2% of cases by about 36 hours from when symptoms begin, and has that figure climbing a further 5% or so with each 12 hours that go by without proper medical treatment.",
        "The primary treatment remains surgical - StatPearls has surgery as the first option for acute appendicitis still, and antibiotics alone are a hospital decision, not a primary-care one.",
        "An Alvarado score of 7 or more is significantly associated with appendicitis, but a LOW score does not exclude it and must not be used to send someone home.",
        "Pregnancy, the elderly and the immunosuppressed present atypically and are the ones who perforate."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children present less typically and perforate sooner. A child with abdominal pain, vomiting and any right-sided tenderness goes to hospital the same day, not to a review appointment.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "acute-appendicitis"
    }
  ]
}