There’s encouraging news for those with a sore appendix and dreading the inevitable surgery that comes from the condition. A new study by Finnish researchers shows that antibiotics may remove the need of surgery for patients who have mild cases of of the condition.
Surgery (an appendectomy) to remove the appendix is the most common treatment for appendicitis in the USA. There are about 300,000 appendectomies performed annually in the U.S. About 200,000 of them are for uncomplicated cases.
According to a report published in the latest issue of The Journal of the American Medical Association, the Finnish researchers studied more than 500 adults who had uncomplicated appendicitis – their appendixes had not ruptured and there were no signs of infection or other problems. Half had undergone an appendectomy, while the other 50 % received an IV of antibiotics followed by a course of antibiotic pills for a week.
Of the patients who took antibiotics, 73 % recovered from appendicitis and did not need surgery for at least a year afterward. The rest of the patients who had another case of appendicitis needing an appendectomy, showed no higher rate of complications than the patients who initially received surgery.
An editorial accompanying the study said “the time has come to consider abandoning routine appendectomy for patients with uncomplicated appendicitis.”
Dr. Paulina Salminen, a surgeon at the Turku University Hospital in Finland and lead author of the stud,y said the treatment of appendicitis with antibiotics “is quite a radical change in the line of thinking, because appendectomy has served patients well for over 100 years”.
The findings show that for patients with uncomplicated cases – about 80% of patients diagnosed with appendicitis – surgery may not be necessary. However, Salminen warned that if the appendix has ruptured, emergency surgery must be done because patients can develop deadly infections in the abdomen and antibiotics alone are not strong enough to treat them.
Because the study only looked at people between 18 and 60, it is not clear how effective antibiotic therapy would be in children, the group that accounts for most cases of appendicitis. Other researchers are planning to do a similar study in children, Salminen said.
Dr. Curtis Wray, associate professor of surgery at the University of Texas Health Science Center, said it was important to determine who the candidates for nonoperative therapy were. If antibiotic therapy does become a viable alternative to appendectomy, it would also probably lead to a big cost savings according to Wray.
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