A new study revealed that use of antibiotics is a reasonable alternative to surgery to treat children with uncomplicated acute appendicitis.
Researchers at Nationwide Children’s Hospital found that surgery isn’t always necessary. Experts were able to treat three out of four children with uncomplicated appendicitis with antibiotics alone.
Appendicitis, caused by a bacterial infection in the appendix, is the most common reason for emergency abdominal surgery in children. Nearly 200 children a day undergo emergency appendectomies in the U.S.
The study, conducted in the United States for non-operative management for appendicitis, involved 102 patients aged 7 to 17, and were diagnosed with appendicitis. 37 families selected antibiotics alone, while 65 opted for surgery.
Patients in the non-operative group received IV antibiotics for at least 24 hours, followed by oral antibiotics after discharge for a total of 10 days. Up to 95% showed improvement within 24 hours and were discharged without undergoing surgery.
Rates of appendicitis-related medical care within 30 days were similar between the groups with two patients in the non-operative group readmitted within 30 days for an appendectomy. At one year after discharge, three out of four patients in the non-operative group did not have appendicitis again and have not undergone surgery.
“Families who choose to treat their child’s appendicitis with antibiotics, even those who ended up with an appendectomy because the antibiotics didn’t work, have expressed that for them it was worth it to try antibiotics to avoid surgery,” stated Peter C. Minneci. “These patients avoided the risks of surgery and anesthesia, and they quickly went back to their activities.”
Dr. Minneci said that although surgery is required for many cases, there are a good number of people who would be given antibiotics alone.
Dr. Minneci is 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.