New research suggests antibiotics may be an effective and surgery-free treatment for appendicitis.
Over 300,000 appendectomies are performed in the U.S. every year, but a recent study found most patients who received antibiotic therapy did not require the invasive surgery, the JAMA Network Journals reported.
"The time has come to consider abandoning routine appendectomy for patients with uncomplicated appendicitis. The operation served patients well for more than 100 years. With development of more precise diagnostic capabilities like CT and effective broad-spectrum antibiotics, appendectomy may be unnecessary for uncomplicated appendicitis, which now occurs in the majority of acute appendicitis cases," Edward Livingston, of JAMA, Chicago, and Corrine Vons, of the Jean Verdier Hospital, commented in an accompanying editorial.
A team of researchers randomly assigned 530 patients with uncomplicated acute appendicitis to receive antibiotic therapy for 10 days or a standard appendectomy. Out of the 273 patients randomized to the surgical group, only one had complications. Of the 256 patients available for 1-year follow-up in the antibiotic group, 72.7 percent did not require an appendectomy. Seventy patients in the antibiotic group underwent surgical intervention within one year of appendicitis onset.
Antibiotic treatment was not show to be a worse course of treatment than surgery within the first year of observations, but 73 percent of patients with uncomplicated acute appendicitis were successfully treated with antibiotics.
"These results suggest that patients with CT-proven uncomplicated acute appendicitis should be able to make an informed decision between antibiotic treatment and appendectomy. Future studies should focus both on early identification of complicated acute appendicitis patients needing surgery and to prospectively evaluate the optimal use of antibiotic treatment in patients with uncomplicated acute appendicitis," the authors wrote.
The findings were published in a recent edition of JAMA.
