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Study Finds Antibiotics Best for Appendicitis
Date:4/6/2012

By Steven Reinberg
HealthDay Reporter

THURSDAY, April 5 (HealthDay News) -- For people suffering from uncomplicated appendicitis, a course of antibiotics may be just as good as having the appendix removed, British researchers report.

The researchers reviewed studies involving hundreds of patients to determine that treatment with antibiotics could be a safe alternative to surgery, which has been the so-called "gold standard" of care for an inflamed appendix since 1889.

"Starting antibiotics when the diagnosis of uncomplicated acute appendicitis is made, with reassessment of the patient, will prevent the need for most appendectomies, reducing patient morbidity," said lead researcher Dr. Dileep Lobo, professor of gastrointestinal surgery at the University of Nottingham and Queen's Medical Centre.

Antibiotics also can shorten a patient's hospital stay, he added.

Since better diagnostic tools are now available to diagnose appendicitis, it is safe to adopt a careful "wait, watch and treat" policy for those who have uncomplicated appendicitis or when the diagnosis is uncertain, Lobo said.

"In these patients, correct diagnosis rather than an early appendectomy is the key," he said. But, he added, "for patients with clear signs of perforation or peritonitis (an inflammation of the abdominal wall), early appendectomy still remains the gold standard."

For the report, which is published in the April 5 online edition of BMJ, Lobo's team did a meta-analysis of four studies in which at total of 900 patients with appendicitis were randomly assigned to surgery or antibiotics.

Among patients treated with antibiotics, 63 percent did not need any further treatment after a year. In addition, antibiotic use resulted in 31 percent fewer complications than surgery, the researchers found.

Among the more than 400 patients treated with antibiotics, 68 had recurrent symptoms. Of those, 13 had serious
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