Nationwide Children’s Hospital receives $2.9 million to investigate nonoperative appendicitis treatment

The Patient-Centered Outcomes Research Institute has awarded $2.9 million to researchers at Nationwide Children’s Hospital for a multi-institutional trial investigating the use of antibiotics as an alternative first-line therapy for children with uncomplicated acute appendicitis, according to a press release.

The study will determine the efficacy of nonoperative treatments across 10 pediatric institutions. If effective, more than 60,000 patients with uncomplicated acute appendicitis may be able to avoid surgery, the release said.

Peter C. Minneci

“Treating appendicitis with antibiotics alone instead of surgery may be preferred by patients and families given its potential for less negative impact on the child and family,” Peter C. Minneci, MD, MHSc, co-director of the Center for Surgical Outcomes Research and principal investigator in the Center for Innovation in Pediatric Practice in The Research Institute at Nationwide Children’s Hospital, said in the release.

The research expands on a previous study conducted at Nationwide Children’s Hospital that found three out of four children with the condition were successfully treated with antibiotics alone. Compared with surgery, the study showed nonoperative treatment resulted in less recovery time and lower health care costs with no difference in complication rates at 1 year.

In the release, Minneci and Katherine J. Deans, MD, MHSc, co-director of the Center for Surgical Outcomes Research and principal investigator in the Center for Innovation in Pediatric Practice in The Research Institute at Nationwide Children’s Hospital, said various stakeholders, including patients, families, primary care practitioners, specialized physicians, payers and health educators, recommended the trial’s design, which allows families to select the best treatment for their child.

Katherin J. Deans

“Our stakeholders felt this would respect the family’s preferences for a particular treatment, make patients and families from different backgrounds feel comfortable to participate in the study, and allow our results to be easily used at other hospitals,” Deans said.

The stakeholders also helped decide which endpoints would provide families with enough information to make an informed decision between antibiotic therapy and surgery.

“We will measure the amount of time the child misses from everyday activities and the success of nonoperative management at 1 year,” Minneci said in the release. “Other important results include disability for the caregiver, quality of life after treatment, satisfaction with care, the percent of patients with complicated appendicitis and treatment complications.”

Reference:

Minneci PC, et al. JAMA Surg. 2015;doi:10.1001/jamasurg.2015.4534.

Disclosure: The researchers report no relevant financial disclosures.