Antibiotics for Appendicitis

The prospect of surgery for those suffering from appendicitis has long been perceived as almost a given. However, this traditional knowledge may not be as certain as it was once believed to be. Researchers have been working to determine if an alternate treatment—a regimen of antibiotics—may be effective in eliminating the need for more invasive tactics.

Read on for an overview of the study they conducted, the data they collected, and what it means in a more practical sense!

The Study

Included in this study were 1,552 adult appendicitis patients from 25 United States centers. These patients received either antibiotic therapy, which consisted of a 10-day course of antibiotics or an appendectomy to treat their appendicitis.

Several outcomes were measured and evaluated over the course of the study. The primary outcome used the European Quality of Life-5 Dimensions questionnaire to determine their 30-day health status. Higher scores on this scale are indicative of a better health status.

Secondary outcomes were also measured and included those in the antibiotics group that required an appendectomy and any complications over 90 days.

Findings

Of the 1,552 adults, 414 had an appendicolith. 776 of the participants were placed in the antibiotics group, while the remaining 776 underwent appendectomy.

Based on the results of the European Quality of Life-5 Dimensions questionnaire, the use of antibiotics was non-inferior to appendectomy. However, some important findings paint a more complex picture.

29% of those in the antibiotics group underwent appendectomy within 90 days. This included 41% of the participants in the antibiotics group with an appendicolith and 25% without. The antibiotics group also experienced more complications.

It is important to note that the antibiotics group had a higher number of patients with appendicolith, which could have skewed the rate of complications in comparison to the appendectomy group.

Serious adverse events occurred in 4% of antibiotics patients and 3% of appendectomy patients.

What it Means

This study suggests that antibiotics are a suitable alternative to appendectomy when treating appendicitis. This assertion is based primarily on the results of the standard health-status measurement questionnaire that was administered.

Among patients receiving antibiotic treatment for their appendicitis, approximately 3% received an appendectomy within 90 days. The presence of an appendicolith was an indicator that a participant would be at a higher risk of appendectomy and complications.