Navigation Links
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 appendicitis, four had a normal appendix and three were successfully treated with more antibiotics, the researchers noted.

The researchers also found no real differences in the length of hospital stays or the risk of complicated appendicitis between people treated with antibiotics and those who underwent surgery.

Dr. Rodney Mason, an associate professor of surgery at the University of Southern California Keck School of Medicine in Los Angeles, reported similar findings in his own study in the February issue of the journal Surgical Infections. "Antibiotic therapy offers a risk of complications that is significantly less than that of appendectomy," he said.

But patients must be willing to accept the idea that they may have to return for surgery if symptoms recur, he said.

"Patients must be willing to accept an initial failure and subsequent recurrence rate of about 40 percent in exchange for the possibility of foregoing surgery and its associated risks," Mason said. "Having said that, 60 percent of patients will get by without surgery."

"Conservative treatment with antibiotics seems to do better than appendectomy," said Dr. Olaf Bakker, from the University Medical Center Utrecht in the Netherlands and the author of an accompanying journal editorial.

He noted in his editorial, however, that appendectomy does not have a lot of complications, while the researchers found that antibiotic treatment resulted in a 20 percent chance of recurrence within a year.

"Of these recurrences, 20 percent of patients presented with a perforated [appendix] or gangrenous appendicitis," he said. "It is questionable whether a failure rate of 20 percent within one year is acceptable."

These results therefore should be interpreted with caution, he said, and appendectomy "will probably remain the treatment for appendicitis until further studies are done."

One other expert noted that the choice is a complicated one, and part of that involves the costs of each treatment.

Although antibiotics may be cheaper, if patients need to come back for an appendectomy after antibiotics have failed, the total cost might end up being higher, said Dr. Carl Schulman, an associate professor of surgery at the University of Miami School of Medicine in Florida.

In addition, doctors influence a patient's decision by what they say, he added.

"You could say, 'With antibiotics, there is a four-in-five chance that you won't need an operation.' That seems very reasonable," he said. "But you could say, '20 percent of patients do come back after antibiotics and they have to have their appendix out; maybe we should just take out your appendix.'"

The best a patient can do is make an informed choice by asking questions, Schulman added.

More information

For more on appendicitis, visit the U.S. National Library of Medicine.

SOURCES: Dileep Lobo, M.D., professor of gastrointestinal surgery, University of Nottingham, Queen's Medical Centre, U.K.; Olaf Bakker, M.D., department of surgery, University Medical Center Utrecht, Netherlands; Rodney Mason, M.D., Ph.D., associate professor of surgery, University of Southern California Keck School of Medicine, Los Angeles; Carl Schulman, M.D., associate professor of surgery, University of Miami School of Medicine, Miami, Fla.; April 5, 2012, BMJ online


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. False-Positive Mammogram Results May Turn Out Not to Be: Study
2. Infection Might Raise Blood Clot Risk for Older Adults: Study
3. Improved Stem Cell Line May Avoid Tumor Risk: Study
4. Study Suggests Treating Dyslexia Before Kids Learn to Read
5. Wellesley study shows income inequality a key factor in high US teen births
6. Study finds doctors have exaggerated fears when starting patients on insulin
7. Berries, Tea May Cut Mens Odds for Parkinsons: Study
8. Soy may alleviate hot flashes in menopause, large-scale study finds
9. Sexual objectification of female artists in music videos exists regardless of race, MU study finds
10. Narcissists Often Ace Job Interviews, Study Finds
11. Early Study Finds Some Promise for Lung Cancer Vaccine
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Study Finds Antibiotics Best for Appendicitis
(Date:5/31/2016)... ... May 31, 2016 , ... Like jewels in a crown, the ... – London is home to Ontario’s leading day spa and one of Canada’s few ... began with a unique concept to combine spa services with hair and beauty ...
(Date:5/31/2016)... (PRWEB) , ... May 31, 2016 , ... WaterField Designs, ... digital-minded professionals, announces the waxed-canvas and leather Duo Dopp Kit , the ideal ... canvas or ballistic nylon, the Duo is smartly designed for Dad’s grooming ...
(Date:5/31/2016)... , ... May 31, 2016 , ... Spectrum Aquatics has ... new lift has been designed and built with the user in mind. , “Over ... consultants have informed us that an ADA 400 lbs lift is a necessary requirement ...
(Date:5/31/2016)... CA (PRWEB) , ... May 31, 2016 , ... Interest ... a primary screening tool and as an orthogonal tool for RNAi hit validation. A ... functional and specific guide RNAs—allows rapid generation of CRISPR RNA (crRNA) collections in arrayed ...
(Date:5/31/2016)... ... May 31, 2016 , ... TeaZa® Energy, LLC announces ... on World No Tobacco Day . The new flavor—Tropical TeaZa? Energy—will be ... this summer. , The new flavor is best described as a juicy, taste ...
Breaking Medicine News(10 mins):
(Date:5/26/2016)... 2016 Since its commercial introduction ... essential life science tool for conducting genetic studies in ... reveals in its new report that the industry sits ... powered by a range of new applications in the ... http://photos.prnewswire.com/prnh/20140723/694805 ) , Since the ...
(Date:5/25/2016)... , Germany and GERMANTOWN, ... QIAGEN N.V. (NASDAQ: QGEN ; Frankfurt Prime Standard: ... licensing and co-development agreement with Therawis Diagnostics GmbH to develop ... be to develop and market PITX2 as a marker to ... high-risk breast cancer patients. "We are pleased to ...
(Date:5/25/2016)... , May 25, 2016 As ... Expo earlier this month, the numbers and momentum of ... to climb into the billions, more research and development ... 4th Edition State of Legal Marijuana Markets Report  from ... data-analysis firm, much of the increase in sector is ...
Breaking Medicine Technology: