Antibiotics as effective as surgery for appendicitis

A year after treatment, 75 percent of patients in the study treated with antibiotics had not had a recurrence of appendicitis and did not have surgery.

By Stephen Feller

COLUMBUS, Ohio, Dec. 16 (UPI) -- Surgery has been the longtime standard to treat appendicitis because it eliminates the chance of the infection coming back, but after doctors at Nationwide Children's Hospital noticed patients given antibiotics overnight before surgery felt fine the next day. This, they say, made them wonder if surgery is really required.

In a new study of children with appendicitis, doctors found antibiotics were as safe and effective at treating many patients, eliminating the need for surgery and the complications that come with it.


"Families who choose to treat their child's appendicitis with antibiotics, even those who ended up with an appendectomy because the antibiotics didn't work, have expressed that for them it was worth it to try antibiotics to avoid surgery," said Dr. Peter C. Minneci, co-director of the Center for Surgical Outcomes Research at Nationwide Children's Hospital, in a press release. "These patients avoided the risks of surgery and anesthesia, and they quickly went back to their activities."

Researchers enrolled 102 patients between the ages of 7 and 17 who were diagnosed with uncomplicated acute appendicitis at the hospital between October 2012 and March 2013, giving families the option to try treatment with antibiotics or go straight to surgery.


Of the families, 37 chose antibiotics alone and 65 went with surgery. Those who chose antibiotics were treated with with intravenous antibiotics for 24 hours and oral antibiotics for 10 days after discharge from the hospital. Of those, 95 percent showed improvement within 24 hours. One year after treatment, 75 percent of the patients did not have appendicitis again and had not had surgery.

"We believe that the results of our study reflect the effectiveness of offering non-operative management to patients and their families in clinical practice," said Dr. Katherine Deans, also co-director of the Center for Surgical Outcomes Research at Nationwide Children's Hospital. "The patient choice design allows the patient and family's preference to be aligned with their choice of therapy."

The study is published in JAMA Surgery.

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