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Antibiotics effective treatment for uncomplicated acute appendicitis without surgery
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Antibiotics as an alternative to surgery for uncomplicated acute appendicitis could lead to less pain and fewer missed school days, according to recent study findings published in the Journal of the American College of Surgeons.
Katherine J. Deans, MD, MHSc, FACS, and Peter C. Minneci, MD, MHSc, FACS, of the Center for Surgical Outcomes Research at The Research Institute at Nationwide Children’s Hospital, and colleagues evaluated 77 children aged 7 to 17 years with uncomplicated acute appendicitis to determine the 30-day success rate of non-operative management. Thirty patients chose non-operative management and 47 chose surgery. Patients in the non-operative group were admitted to the hospital and received IV antibiotics for at least 24 hours and oral antibiotics after discharge to complete 10 total days of antibiotics.
"Based on the current study, children with uncomplicated appendicitis are good candidates for non-operative management," Deans said in a press release.
There was a 93% immediate success rate for non-operative management and a 90% 30-day success rate. The patients who failed non-operative management underwent an appendectomy, however, none had an appendix rupture.
The non-operative group had a longer hospital length of stay (38 hours) compared with the operative group (20 hours). However, the non-operative group was able to return to school and normal activities quicker than the operative group.
“With our pilot project, we started with the group of patients who would be most likely to have success with an antibiotics-only approach and would be least likely to be harmed, but the next step is to try to slowly add some of the patients who were excluded in the preliminary study to see how well they do,” Minneci said in a press release. “It may get to the point that non-operative management becomes the initial therapy for all appendicitis, but we won’t know that until we do further studies.”
Katherine J. Deans, MD, MHSc, FACS, can be reached at katherine.deans@nationwidechildrens.org.
Peter C. Minneci, MD, MHSc, FACS, can be reached at peter.minneci@nationwidechildrens.org.
Disclosure: The study was funded in part by the NIH and Research Institute at Nationwide Children’s Hospital.
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