A new study published by JAMA reveals that patients suffering from appendicitis who were treated with a 10 day course of antibiotics, rather than undergoing surgery had a 73% recovery rate, even a year after the study was conducted.
The standardized treatment for patients with appendicitis has been an appendectomy, but all surgeries come with risks. So are antibiotics a safer and just as effective treatment for patients with appendicitis?
Out of 256 patients who were treated with antibiotics alone, 186 did not require any further treatment at a one-year follow-up.
This compared to surgical intervention didn't prove to be quite as effective. 70 of these patients did go on to require appendectomies within one year of the initial symptoms.
According to this study treatment with antibiotics would not be worse that having an appendectomy. The benefits from avoiding the appendectomy would certainly be worthwhile even at a failure rate of 24% in the antibiotic group.
delaying appendectomy and trying antibiotic treatment first was shown by the lack of intra-abdominal abscesses or other major complications.
The use of antibiotics perioperatively and computed tomography is changing modern treatment for appendicitis.
Dr. Edward Livingston, JAMA's deputy editor, and Dr. Corrine Vons, from the Jean Verdier Hospital in Bondy, France - explains that since late in the 19th century, surgery has remained unquestioned in the treatment of appendicitis.
"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."
"These results suggest that patients with CT-proven uncomplicated acute appendicitis should be able to make an informed decision between antibiotic treatment and appendectomy."
Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: the APPAC randomized clinical trial, Paulina Salminen et al., JAMA, published online 16 June 2015, doi: 10.1001/jama.2015.6154, abstract.
Treating appendicitis without surgery, Edward Livingston and Corrine Vons, JAMA, published online 16 June 2015, editorial.