In children and teens, appendicitis is the most common cause of surgery; every year, 70,000 young people undergo surgery because of the bacterial infection. But a new study about a nonsurgical treatment for appendicitis could change that. Researchers from Nationwide Children's Hospital say that using antibiotics could be just as effective as surgery in treating appendicitis.
"Surgery has long been the 'gold standard' of care for treating appendicitis because by removing the appendix we eliminate the chance that the appendicitis will ever come back," study author Dr. Katherine J. Deans said in a press release. "However, early in our careers we noticed that patients with appendicitis who were placed on antibiotics overnight until their surgery the following morning felt better the next day. So, Pete [Dr. Peter C. Minneci] and I asked ourselves: do they really need to have surgery?"
The researchers studied 102 patients aged 7 to 17 years old who had uncomplicated accute appendicitis. All of them exhibitied symptoms of early appendicitis, such as abdominal pain that did not persist for more than 48 hours. Their ultrasound and CT scans showed their appendix did not rupture.
Out of 102 patients, 37 chose to be treated with antibiotics alone while 65 chose appendectomy. The no-surgery group was given IV antibiotics for 24 hours and oral antibiotics for 10 days. Of the 37 patients, 95 percent showed improvement in just a day and were discharged without the need for an appendectomy. One year after the treatment, the appendicitis recurred only in one out of four patients.
"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," lead researcher Minneci said.
Deans said their study results show "the effectiveness of offering non-operative management to patients and their families in clinical practice. The patient choice design allows the patient and family's preference to be aligned with their choice of therapy."
The study was published online Dec. 16 in the journal JAMA Surgery.