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Study suggests Surgical Risk Reduced by treating Appendicitis with Antibiotics


A recent study reaffirms antibiotics could be a viable option for children suffering from appendicitis.

The appendix is a vestigial organ, a short tubular segment of intestine attached to your colon on the lower right side with no active known use.  At present there is some suggestion by researchers that the appendix may be a reservoir for useful bacteria, but the organ is considered expendable when it becomes obstructed and inflamed, a condition called appendicitis.    Left untreated, the appendix can expand and eventually burst, spilling infection into the abdominal cavity, a dangerous and potentially deadly condition known as peritonitis.

Appendicitis is the most common cause of emergency abdominal surgery, impacting about 80,000 children each year.  While appendicitis is most common in people ten to 30 years of age, appendicitis can occur at any time throughout life.

While surgical removal of the appendix is the most common treatment option, ongoing research supports the viability of antibiotics as a means of treating appendicitis without the risks associated with open or laparoscopic surgery.  Complications and error can occur with any surgery leading to infection, inadvertent removal of only part of the appendix, blockage of the bowels, incisional hernia, or other mistaken injury to internal organs during the procedure.

A recent study published in the journal JAMA Network provides additional support to earlier studies suggesting treatment with antibiotics reduces surgical risk and days to recovery for children with uncomplicated appendicitis (when the appendix has not become so inflamed that it has burst or been perforated).

Antibiotics as an alternative to surgery

Researchers reviewed data from 1068 patients.  Of these, 67.1 percent of patients who opted for antibiotics instead of surgery were successfully treated, suffering no side effects and losing less time to recovery than patients who had an appendectomy.

For children, that result means less pain and suffering and quicker return to day-to-day activities.   The study notes patients provided antibiotics were those who had been in pain less than 48 hours, underwent imaging studies to confirm the appendix had not ruptured, and met standards with regard to their white blood cell count.

Lead investigator, Dr. Peter Minneci stated, “For surgery, patients need to go under general anesthesia, and there is 1-2% chance of a major complication and 5-10% chance of a minor complication.” Change is slow, but when indicated, antibiotics may become a leading treatment for uncomplicated appendicitis without resorting to surgery.

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