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Antibiotics alone are a successful treatment for uncomplicated acute appendicitis in kids
Date:4/14/2014

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery that leads to less pain and fewer missed school days, according to a pilot study. The research, led by a team at Nationwide Children's Hospital and published online April 12 in the Journal of the American College of Surgeons, is the first prospective study on nonoperative management of acute appendicitis in pediatric patients in the United States.

Researchers enrolled 77 patients age 7 to 17 who were diagnosed with uncomplicated acute appendicitis by a surgeon in the Emergency Department at Nationwide Children's between October 2012 and October 2013. Participants had experienced abdominal pain for no more than 48 hours; had a white blood cell count below 18,000; underwent an ultrasound or CT scan to rule out rupture and to verify that their appendix was 1.1 cm thick or smaller; and had no evidence of abscess or fecalith, which is hard stone made of calcified stool.

Thirty patient families chose antibiotics alone and 47 opted for surgery. Those in the non-operative group were admitted to the hospital and received IV antibiotics for at least 24 hours, followed by oral antibiotics for a total of 10 days after discharge. Among those patients, 93 percent showed improvement within 24 hours. Three patients ultimately underwent an appendectomy when the symptoms failed to resolve, but none experienced an appendix rupture.

"Based on the current study, children with uncomplicated appendicitis are good candidates for non-operative management," says Katherine J. Deans, MD, who led the study with Peter C. Minneci, MD. The pair are co-directors of the Center for Surgical Outcomes and principal investigators in the Center for Innovation in Pediatric Practice in The Research Institute at Nationwide Children's.

Appendicitis, caused by a bacterial infection in the appendix, is the most common reason for emergency abdom
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Contact: Gina Bericchia
Gina.Bericchia@NationwideChildrens.org
614-355-0487
Nationwide Children's Hospital
Source:Eurekalert

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