Antibiotics May Be Effective Treatment for Appendicitis: Study

While surgery is commonly recommended for treatment of appendicitis, the findings of a new study suggest that use of antibiotics may be a better alternative, avoiding the risks associated with surgery. 

In findings published this week in the Journal of the American Medical Association (JAMA), researchers from Finland indicate that antibiotics for appendicitis treatment appears to be a better treatment options for many patients than undergoing surgery.

Traditionally, appendectomy has been the standard treatment for uncomplicated cases of appendicitis. Appendectomy is a surgery that creates an incision to completely remove the appendix from the body. This is mainly because doctors are attempting to prevent the organ from bursting and prevent the spread of infection. However, this new study suggests treating uncomplicated appendicitis with a strong course of antibiotics may help reduce the inflammation and prevent the appendix from bursting.

The five year observational study was conducted in Finland from November 2009 to June 2012, including 530 patients ages 18 to 60, with a CT scan confirming appendicitis. A total of 273 patients underwent appendectomy surgery and 257 patients were treated with antibiotics.

Appendicitis is an inflammation of the appendix, which is an organ that extends from the large intestine. It is thought to be caused by a blockage in the organ. Left untreated, the appendix will eventually burst and cause serious complications, including severe pain and infection, which can be fatal as it spreads to the rest of the body.

Roughly one in 20 Americans will get appendicitis in their lifetime. It typically occurs between the ages of 10 and 30.

Patients in the antibiotic group received intravenous ertapnem for three days followed by seven days of oral levofloxacin and metronidazole.

Overall, 70 patients, about 27%, who were initially treated with antibiotics required appendectomy surgery within the first year.

The recurrence rates of appendicitis after being treated with antibiotics instead of surgery were 34% at two years, 35.2% at three years, 37.4% at four years, and 39% by the five year followup mark. Recurrence rates did not increase drastically during the five year followup.

The complication rates at the five year mark were 24% in the appendectomy surgery group and only 6.5% in the antibiotic group. Complications included surgical site infections, incisional hernias, abdominal pain, and obstructive symptoms.

Based on the short-term five year results, treating appendicitis with antibiotics may be a good alternative compared to appendectomy surgery, the researchers concluded.

While the short-term results are promising as an alternative treatment, the long term results are largely unknown and require further study.