Antibiotic Treatment a Viable Alternative to Appendix Surgery


New research has shown that kids with appendicitis may be better off with an IV transfusion of antibiotics than with having surgery.

WPVI-TV Philadelphia reports that although surgery has been the standard treatment for appendicitis and is one of the most common childhood operations with over 200 surgeries a day in the US, this new approach is a breakthrough.

The kids who had the infusion of antibiotics were also given pills to take at home. Three out of four kids who took the antibiotics did not need surgery after one year. Doctors say everybody wins.

Dr. Pete Minneci, a co-author of the study at Nationwide Children’s Hospital, said the children do not have the pain that comes with surgery, so they don’t need pain relievers. With no surgery, there does not have to be the risk of operating or anesthesia-related problems.

But doctors caution that the antibiotic-only procedure should be used only with early appendicitis when there are no complications, and if the case is not overly severe. Dr, Kate Deans, the co-leader of the study, said parents need to decide on the method that is best for them. Having the antibiotic option available could keep thousands of children out of the operating room annually.

Also, kids have a shorter recovery periods and end up with a less expensive healthcare bill than the kids whose families chose the surgery route.

“There is a relatively good body of literature in adults and also in children that shows patients and parents involved in the decision process do better,” said Dr. Peter Minneci, of The Research Institute at Nationwide Children’s Hospital in Columbus, Ohio.

The appendix is a small pouch of tissue attached to the large intestine. When this tissue becomes inflamed, that condition is called appendicitis, which can occur when there is an infection, blockage, trauma, or intestinal disorders such as Crohn’s disease.

“By allowing the patient to be involved in the decision process you are allowing them to align their preference and beliefs with the care themselves,” Minneci told Reuters Health.

NBC News reports that the scientists screened 629 young people between the ages of seven and 17 who arrived in the emergency room in October 2012 to March 2013 with appendicitis. Of those children, 22% did not have severe or complicated cases, which made them eligible for the study. In the end, 102 families enrolled. Thirty-seven of these families chose the 24 hours of IV antibiotics followed by ten days of oral antibiotics treatment. The rest of the families chose surgery.

After a year, 76% of the antibiotic children were healthy and needed no extra treatment. These kids also needed 13 fewer rest days and had medical bills an average of $800 less.

Two patients in the antibiotic group had to come back to the hospital within 30 days to have an appendectomy, according to The Philadelphia Inquirer. The physicians cautioned that appendicitis presents in multiple ways and not all of which are compatible with the antibiotic-only treatment.

RTT News reports that the study was published in JAMA Surgery and the researchers concluded that:

non-operative management is an effective treatment strategy for children with uncomplicated acute appendicitis, incurring less morbidity and lower costs than surgery.”

12 18, 2015
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