Antibiotics can treat appendicitis without surgery | Smart News

When a patient comes to the hospital with appendicitis, the standard procedure is to remove the appendix during an emergency surgery. But as the Associated Press reports, a new study published in the Journal of the American Medical Association suggests that there may be an effective but less invasive alternative to the treatment of appendicitis: antibiotics.

Appendicitis is characterized by inflammation of the appendix, a small sac that protrudes from the colon. The condition is probably caused by a blockage in the lining that causes an infection. Doctors act quickly to eliminate inflamed appendages as they may rupture, potentially putting the patient's life at risk.

Advances in computed tomography (CT), however, have made it easier for physicians to determine if an appendix is ​​about to break. According to Nicolas Bakalar of The New York TimesRecent research has shown that antibiotics may be an appropriate treatment for uncomplicated acute appendicitis or, in cases where the appendix has not broken up, the number of white blood cells is low and it is n & # 39; There is no faecal blockage. However, the long-term results of the surgery are unclear.

The new study, conducted by Finnish researchers, followed more than 250 adults for five years after the administration of antibiotics – three days of intravenous antibiotics at the hospital, and then seven days at home – as treatment for appendicitis in a randomized trial. The team compared this group to 270 other patients who had an appendectomy.

Among antibiotic patients, approximately 64% of the group did not require surgery within five years of antibiotic therapy. One hundred finally had an appendectomy; 70 of them in the first year after the initial treatment. Most surgical procedures were necessary due to a recurrent case of appendicitis, but seven of the patients returning home did not actually have any. It is also important to note that delaying surgery does not seem to have a negative effect on patients who eventually needed an appendectomy.

Those who received antibiotics took 11 fewer days off, on average, than the surgery group. Only seven percent of the group's antibiotics had post-treatment complications, compared to one in four patients with conditions such as hernias, abdominal pain and surgical incision infections.

Dr. Paulina Salminen, surgeon at Turku University Hospital in Finland and lead author of the study, told AP that antibiotics should therefore be considered as a "feasible, viable and safe option" for treating uncomplicated appendicitis.

However, there are advantages to simply doing the standard treatment. As Edward H. Livingston, the Deputy Director of JAMA, notes in an editorial that accompanies the new study, appendicectomies implicate relatively few major complications and offer patients the peace of mind that an appendicitis attack will not happen again. It is also important to note that surgeries in the Finnish study had all been performed with conventional incisions; In the United States, according to the AP, less invasive "keyhole surgeries" performed laparoscopically with small incisions are more common in appendectomies.

And yet, Livingston writes, the new findings "dispel the idea that uncomplicated acute appendicitis is a surgical emergency." Patients should be informed of the possibility of possibly needing an appendectomy, but starting with nonsurgical treatment in some cases, he says, is a "reasonable option".

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