When appendicitis strikes, an operation to remove the appendix has long been the route to recovery. But a new strategy called “antibiotics first” could help some people avoid surgery for appendicitis. In a clinical practice article in today’s New England Journal of Medicine, Dr. David Flum, a surgeon at the University of Washington in Seattle, explores the history of antibiotics first for appendicitis, how it is currently being used, who might benefit from this no-surgery approach, and its drawbacks. Appendicitis 101 The appendix is a small, finger-like tube that hangs from the lower right side of the large intestine. Exactly what it does is something of a medical mystery. In about 300,000 Americans a year, the appendix becomes inflamed, usually because of an infection or