Antibiotics for Appendicitis May Save Patients From Surgery

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By Lauren Holter | April 7, 2012 6:39 AM EST

It now seems possible that antibiotics could treat some patients with appendicitis better than surgery.

Appendectomy, the surgical removal of the appendix, has been the primary treatment for appendicitis for decades, but a new study found that it may not be necessary.

According to TIME, British researchers from the Nottingham Digestive Diseases Centre Biomedical Research Unit report that patients with uncomplicated appendicitis may be effectively treated with standard antibiotics. Avoiding surgery also reduces the risk of complications and death.

However, for cases involving perforated appendixes, surgery is still necessary.

In a test involving 900 adult patients with uncomplicated acute appendicitis, 470 received antibiotics and 430 had surgery. The researchers found that 63 percent of patients who received antibiotic treatment were symptom-free after a year and had a 31 percent lower risk of complications.

About 20% of patients who received antibiotics were eventually readmitted to the hospital with recurring symptoms and 13 percent had complicated appendicitis, requiring surgery.

"The role of antibiotic treatment in acute uncomplicated appendicitis may have been overlooked mainly on the basis of tradition rather than evidence," the researchers said in their British Medical Journal publication of the study. "Antibiotics are both effective and safe as primary treatment for patients with uncomplicated acute appendicitis."

In the U.S., about 250,000 people have their appendix removed each year.

"We're not saying antibiotics are going to replace surgery altogether," Dr. Dileep Lobo, professor of gastrointestinal surgery at the University of Nottingham and Queen's Medical Centre, told WBUR. Surgery should still be the gold standard of care, he says, in cases where patients are exhibiting symptoms of complicated appendicitis.

"If you treat the 80 percent of patients with uncomplicated appendicitis with antibiotics, you'll probably save about 60 percent of those patients from having an operation," Lobo adds.

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