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 i
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