A review article published Tuesday in JAMA has found that antibiotics can be used as first-line therapy for uncomplicated appendicitis cases, according to Science Daily.
Numerous studies have demonstrated that antibiotics work just as well as surgery for most uncomplicated appendicitis cases and this non-invasive approach can be considered a routine option.
The findings suggested that antibiotics successfully treated up to 70% of appendicitis cases.
Currently, surgery, especially laparoscopic, is the only definitive option for otherwise healthy patients with severe appendicitis that may increase the risk of rupture.
Lead author Dr. Theodore Pappas of Duke University School of Medicine said, “Acute appendicitis is the most common abdominal surgical emergency in the world, striking about one in 1,000 adults.”
“Until recently,” he added, “the only treatment option was surgery, so having a non-surgical approach for many of these cases has significant impact for both patients and the health care system.”
Dr. Pappas also said the criteria for determining the best treatment approach is nuanced but not excessively difficult.
Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen, according to Mayo Clinic.
It causes pain in your lower right abdomen. However, in most people, pain begins around the navel and then moves. Other symptoms include nausea, vomiting, and low-grade fever. Appendicitis is diagnosed with a sonogram and/or CT scan.
If the imaging depicts no complications, most patients could receive antibiotics instead of getting an appendectomy done. Antibiotics could play a key role in patients who have severe symptoms and who are older or have certain medical conditions that add risks to surgeries.
Dr. Pappas said, “We think it’s going to be 60% to 70% of patients who are good candidates for consideration of antibiotics. A lot of people note that patient preferences can be brought into the decision, so it is important to provide the literature and educate the public.”
However, Dr. Pappas said that antibiotics are not always a complete cure for appendicitis. He explained that about 40% of patients who recover from a bout of appendicitis after receiving antibiotics may have another episode, eventually needing an appendectomy.
Dr. Pappas noted, “It’s important to take into account every case and it’s unique context as we consider patient preferences.”
“If someone presents with an appendicitis and they’re attending their brother’s wedding the next day, antibiotics may be a good option,” he added. “If they have appendicitis and they are planning to head to rural Alaska next year, they might want to consider an appendectomy, given that the condition could recur.”
