For decades, surgeons have commonly treated acute appendicitis by removing the inflamed organ. However, research performed by a group of scientists from Finland tested the theory of prescribing antibiotics to patients demonstrating appendicitis symptoms in lieu of performing surgery. Their findings were published in the September 25, 2018 issue of “JAMA.”
Different trial studies have taken place over the years to determine the effectiveness of antibiotic therapy as opposed to surgery for treating appendicitis. However, The studies never concluded whether or not the treatment was a temporary solution or could possibly have exacerbated the condition.
The Finland study spanned five years, involved 530 patients and provided more clarity to the topic. The results of the trial indicated that nearly two-thirds of the study participants did not require follow-up appendectomies. The number of patients needing later surgery determined that the patients were not in a more serious state. Additionally, some of the surgery candidates were found not to have appendicitis.
The patients were 18 to 60 years of age and were diagnosed as having uncomplicated appendicitis. Uncomplicated cases have no symptoms of abscess, tissue perforations or tumorous growths. Of the 530, 256 received antibiotic therapy. The regimen involved three days of IV medications in the hospital followed by outpatient oral antibiotics. The type of antibiotics prescribed were not noted. The researchers also shared that the extent of therapy may not have been necessary and that a shorter course of action may eventually prove effective.
After the first year, 70 of the antibiotic-treated patients required appendectomies. Five years later, another 30 patients underwent surgery. Overall, 61 percent of the appendicitis patients did not require surgical intervention.
Successfully treating patients suffering appendicitis with antibiotics instead of surgery offers many different benefits. In the United States, the surgery commonly chosen is a less invasive laparoscopic procedure. However, though less invasive, surgery costs far more than antibiotic therapy. Patient receiving IV or oral antibiotics do not have the need to recover for four to six weeks as do post-operative patients. By being able to return to normal work schedules, antibiotic-treated patients do not suffer a loss of wages. They also do not have to worry about paying the difference not covered by health insurance, which also saves money.
Further research will enable scientists to refine antibiotic treatment options for appendicitis based on the severity of the condition combined with the specific characteristics of each patient.