Antibiotics can treat appendicitis, but long-term efficacy unknown

A review of studies showed about a quarter of patients treated with antibiotics have a recurrence within a year.

By Stephen Feller

HELSINKI, Finland, March 18 (UPI) -- Mild appendicitis can be treated successfully with antibiotics for at least a year, but risk for recurrence of the infection increases sharply after that, according a recent study in Finland.

Researchers at the University of Helsinki found no great differences in complications between people who have their appendix removed and those treated with antibiotics, though some patients later needed surgery and others had appendicitis about a year after the treatment.


Two small studies in 2015, conducted at Turku University Hospital in Finland and Nationwide Children's Hospital in Ohio, showed about a quarter of patients treated with antibiotics needed surgery within a year.

For the new study, published in the British Journal of Surgery, researchers analyzed results from five studies with 1,116 patients. They found about 5 percent of patients given antibiotics and 8 percent who had surgery experienced serious complications.

Used as a primary treatment, the researchers reported a 92 percent decline in surgeries, although 23 percent of patients given antibiotics had a recurrence of appendicitis within 12 months.

Based on the evidence available, and without long-term follow-ups with patients treated only with antibiotics, researchers said they can't recommend establishing antibiotics as the first mode of appendicitis treatment because of other health variables.


Concerns about longer-term chance for recurrence, an increasing caution about antibiotic overuse leading to resistance, and the requirement that appendicitis be confirmed with a CT scan before antibiotics are used for treatment lead researchers to suggest the choice remains between doctors and patients.

"In medicine and surgery, treatment choices are increasingly based on shared decision-making, where patients and care providers make decisions together," Kari Tikkinen, an adjunct professor at the University of Helsinki, said in a press release. "I expect that this will also increasing apply to treatment of mild appendicitis."

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