Navigation Links
Surgery May Beat Antibiotics for Appendicitis, Study Finds
Date:5/6/2011

By Steven Reinberg
HealthDay Reporter

THURSDAY, May 5 (HealthDay News) -- Although some researchers believe antibiotics can often cure appendicitis, surgery remains the more effective treatment, French investigators suggest.

Uncomplicated appendicitis may be treated with antibiotics alone, but complicated appendicitis, where the appendix is perforated, requires surgery, and it is difficult to discern between the two, the researchers say.

"With the current technology, it is not possible to distinguish between uncomplicated and complicated appendicitis," said lead researcher Dr. Corinne Vons, of the Assistance Publique-Hopitaux de Paris and Universite Paris XI.

"Therefore, we cannot treat uncomplicated appendicitis with antibiotics," she said. In the future, with improved imaging, "it will be possible," she said.

The report was published in the May 7 edition of The Lancet.

For the study, Vons' team followed 239 patients diagnosed with uncomplicated acute appendicitis, based on a CT scan, who were randomly assigned to treatment with antibiotics or an appendectomy. The researchers looked for cases of peritonitis, an inflammation of the wall of the abdominal cavity, in the 30 days following treatment.

They found that those treated with antibiotics -- 3 grams of amoxillin plus clavulanic acid for 8-15 days -- had a significantly higher incidence of peritonitis (8 percent), compared with those who underwent surgery (2 percent).

In addition, 21 of the appendectomy patients (18 percent) were found to have complicated appendicitis with peritonitis, despite the CT scan results.

Moreover, 14 patients treated with antibiotics (12 percent) needed an appendectomy during the month after treatment. Another 30 required an appendectomy between one and 12 months after initial antibiotic treatment. More than a quarter of those patients had suffered a recurrence of acute appendicitis, which made the operation necessary, the researchers say.

The study isn't likely to end the debate, however.

One expert, Dr. Rodney J. Mason, associate professor of surgery at the University of Southern California's Keck School of Medicine and author of an accompanying journal editorial, disagrees with the findings.

"There are a lot of biases in the study," Mason said. For one, the researchers gave patients the wrong antibiotic (amoxicillin), to which the most common germ associated with appendicitis -- E.coli -- has developed resistance rates to up to 66 percent in Europe, Mason said. His editorial also noted that amoxicillin-clavulanic acid "is not recommended" in the non-surgical treatment of appendicitis.

And even this study showed that two-thirds of the patients didn't need surgery, Mason added.

In their study, the authors conceded that antibiotic resistance to amoxillin might have affected the results, and suggested that third-generation cephalosporins, though not yet recommended, might be an alternative.

Regarding the latter suggestion, Mason commented: "That depends on the hospital and the sensitivity of that local hospital's organisms to different antibiotics. But a good combination to start out with would be ciprofloxacin combined with metronidazole, or levofloxacin combined with flagyl."

"Each community is going to have different sensitivities to the antibiotics, so a broad generalization should not be made," he added.

Most importantly, "patients with appendicitis need to be given the [idea] that antibiotic therapy is a perfectly acceptable option," Mason said. "There is a good chance that two-thirds of patients will not need an operation," he said.

Doctors don't usually tell patients that antibiotics may be all the treatment they need for appendicitis, Mason said.

There are downsides to the operation as well, he added. "There is always the risk of anesthetic problems, of bleeding, of infections and bowel obstructions later on," he said.

In the future, patients with uncomplicated appendicitis will be treated with antibiotics first, and only if that treatment fails will the patient undergo an operation, Mason said.

"You don't need to have an emergency operation; you can wait a day or so and see if the antibiotics work or not," Mason said. "That is the way we should be going."

More information

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

SOURCES: Corinne Vons, M.D., Ph.D., Assistance Publique-Hopitaux de Paris and Universite Paris XI, France; Rodney J. Mason, M.D., Ph.D., associate professor of surgery, University of Southern California, Keck School of Medicine, Los Angeles; May 7, 2011, The Lancet


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

Related medicine news :

1. Repeated Weight-Loss Surgery Carries Added Risks
2. The New Liposuction Technique Means No Surgery or Suction
3. Research validates surgery alone offers reasonable overall survival for stage I SCLC
4. "New Cosmetic Surgery" Journalism Prize
5. Abington Memorial Hospital Welcomes Vakil to Orthopaedic Surgery Division
6. Drug for advanced kidney cancer shrinks tumors prior to surgery
7. Abington Memorial Hospital Earns Two Designations: Blue Distinction Center for Spine Surgery(SM) and Blue Distinction Center for Knee and Hip Replacement(SM)
8. New endoscopic treatment may spare Barretts esophagus patients from surgery
9. Pittsburgh Neurosurgeons Explore Use of Drug that Illuminates Brain Tumor Cells To Guide Surgery
10. Surgery Alone May Thwart Stage 1 Lung Cancer
11. Comparison shows robot-assisted option offers advantages for kidney surgery
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Surgery May Beat Antibiotics for Appendicitis, Study Finds 
(Date:6/27/2016)... ... June 27, 2016 , ... ... patient payment industry today announced its strategic partnership with Connance, a healthcare ... , The two companies’ proven, proprietary technology combine to provide health systems, ...
(Date:6/27/2016)... ... , ... TopConsumerReviews.com recently awarded their highest five-star rating to Best Buy Eyeglasses, ... the United States and Canada wear eyeglasses. Once considered to be a purely functional ... a fashion statement. Even celebrities use glasses as a way of creating an iconic ...
(Date:6/26/2016)... ... ... On June 10-11, 2016, A Forever Recovery, a holistic treatment center for ... Table in Battle Creek, MI, where the rehabilitation facility is located. This annual celebration ... world’s leading providers of cereal and other breakfast foods. Its residents often refer to ...
(Date:6/26/2016)... ... ... PawPaws brand pet supplements owned by Whole Health Supply is ... of felines. The formula is all-natural and is made from Chinese herbs that have ... Kidney Support Supplement Soft Chews are Astragalus Root Extract and Rehmannia Root Extract ...
(Date:6/26/2016)... Clarkston, Michigan (PRWEB) , ... June 26, 2016 ... ... respect to fertility once they have been diagnosed with endometriosis. These women need ... but they also require a comprehensive approach that can help for preservation of ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 ... of the "Structural Electronics 2015-2025: Applications, Technologies, ... In-Mold Electronics, Smart Skin, ... Photovoltaics Structural electronics involves electronic ... load-bearing, protective structures, replacing dumb structures such as ...
(Date:6/24/2016)... Calif. , June 24, 2016  American Respiratory Labs (ARL), ... is now able to perform sophisticated lung assessments in patients, homes, ... , Inc. Patients are no longer limited to ... EasyOne PRO ® , ARL patients like Jeanne R. of ... in the comfort of her own home. ...
(Date:6/24/2016)... LEXINGTON, Mass. , June 24, 2016   ... specialty pharmaceutical company developing innovative inhaled drugs, announced today ... when Russell Investments reconstituted its comprehensive set ... 2016. "This is an important milestone for ... "It will increase shareholder awareness of our progress in ...
Breaking Medicine Technology: