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:2/6/2016)... (PRWEB) , ... February 06, 2016 , ... Shark ... to announce the launch of a new DRTV campaign with Belly Bands. , Having ... tried everything from sprays to puppy pads and find nothing works, get Belly ...
(Date:2/5/2016)... ... ... Love is in the air at King Kullen! The local grocer is ... staple for Valentine’s Day is a must-have, and can be picked up with all ... are long-stem roses available, but also other flower bouquets, elegantly wrapped and ready to ...
(Date:2/5/2016)... (PRWEB) , ... February 05, 2016 , ... ... and setting the stage for new clinical and scientific initiatives have all marked ... after she was appointed President and CEO of the nation’s oldest cancer center, ...
(Date:2/5/2016)... ... February 05, 2016 , ... Francisco ... micro-needling services in their Napa Valley office. The technique utilizes the body’s own ... Dr. Canales and Dr. Furnas, are part of only a select few cosmetic ...
(Date:2/5/2016)... ... ... After years as an active staff surgeon and having served as the director ... transitioned to chief of the Division of Plastic Surgery at what is now known ... began a second three-year term in January of 2016. , The original selection was ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... Bernstein Liebhard LLP today announced that a securities class ... for the District of Arizona on ... or entities who purchased common shares of Insys Therapeutics Inc. ... 3, 2015 through January 25, 2016 (the "Class Period").  The ... of the Securities Exchange Act of 1934.  ...
(Date:2/4/2016)... 4, 2016 Wegener Polyangiitis - Pipeline ... Direct,s, ,Wegener Polyangiitis - Pipeline Review, H2 2015, ... pipeline. This report provides comprehensive information on ... comparative analysis at various stages, therapeutics assessment by ... administration (RoA) and molecule type, along with latest ...
(Date:2/4/2016)... 2016 Summary Breast cancer, a malignant ... most common cancer in women worldwide, accounting for 16% ... The number of women diagnosed with breast cancer has ... of deaths has declined due to earlier diagnosis and ... revolutionized in the past four decades, especially with increasing ...
Breaking Medicine Technology: