Antibiotics May Be Enough for Appendicitis
He noted, however, that using antibiotics for initial treatment has some disadvantages, including the need for delayed appendectomy in some patients with persistent symptoms, the 20% chance of recurrence within the first year, which may be unacceptable, and the need to perform CT in all patients to rule out perforated appendicitis before starting antibiotics.
On the other hand, appendectomy also has drawbacks, including the need for general anesthesia and the risk of procedure-related complications like wound infection.
Appendicitis
Relatively common, affecting 7% of people in the UK
More common in men
Normally occurs in those between 10-30 years of age
Less common among people who eat a high-fibre diet
A ruptured appendix can lead to potentially serious, or even fatal, complications, such as blood poisoning
Advances in diagnostic and surgical techniques mean deaths are very rare
The researchers “are appropriately circumspect in concluding that conservative treatment merits consideration as a primary treatment option,” Bakker wrote. “However, until more convincing studies and longer-term results are published, appendectomy will probably continue to be used for uncomplicated appendicitis.”
One of Lobo’s co-authors was funded by a research fellowship from the Nottingham Digestive Diseases Center NIHR Biomedical Research Unit.
The study authors reported that they had no conflicts of interest.
Bakker reported that he had no conflicts of interest.
Primary source: BMJ
Source reference: Varadhan K, et al “Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: a meta-analysis of randomized controlled trials” BMJ 2012; DOI: 10.1136/bmj.e2156.
Additional source: BMJ
Source reference: Bakker O “Should conservative treatment of appendicitis be first line?” BMJ 2012; DOI: 10.1136/bmj.e2546.