Clinical recommendation	Evidence rating	References
The Alvarado score, Pediatric Appendicitis Score, or Appendicitis Inflammatory Response score can be used with point-of-care or formal ultrasonography and laboratory testing to help diagnose acute appendicitis and reduce the use of computed tomography.	B	10–12, 14, 15, 18, 27
When skilled sonographers are available, first-line imaging for patients with suspected acute appendicitis consists of point-of-care or formal ultrasonography, especially in children and pregnant women.	C	18, 24, 25
Opioids, nonsteroidal anti-inflammatory drugs, or acetaminophen should be provided to patients with suspected acute appendicitis.	A	28, 29
Open and laparoscopic appendectomies are effective surgical techniques for the treatment of acute appendicitis.	A	1
Intravenous antibiotics can be used as first-line therapy in children and adults with acute appendicitis.	A	4, 31