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October 5 (UPI) – Antibiotics and surgery are good options for treating appendicitis, according to a study published Monday in the New England Journal of Medicine that found that 7 out of 10 patients treated with the drugs eventually avoid surgery.
“About three out of 10 patients in the antibiotic group eventually underwent an appendectomy within 90 days,” study co-principal investigator Dr. David Flum said in a statement.
“There were pros and cons to each treatment, and patients will rate them differently based on their unique characteristics, concerns and perspectives,” said Flum, professor and associate chair of surgery at the University of Washington School of Medicine.
The Antibiotics and Appendectomy Results Comparison is the largest study to date comparing antibiotics for appendicitis to appendectomy, which is surgery to remove the appendix, the researchers said.
The goal of the study is to help nearly 300,000 people who visit the hospital each year for appendicitis-related problems to choose the treatment that would be best for them with the support of the study evidence.
Inflammation of the appendix, which usually occurs in your teens or 20s, is the most common cause of acute abdominal pain that requires surgery, although some mild cases are treated with antibiotics alone.
The study involved 1,552 participants from 25 sites in 14 states, the researchers said. One month after treatment, the participants rated their general health as roughly the same in both groups.
In the antibiotic group, about 71% did not have surgery within three months, and participants in the antibiotic group lost about 3 1/2 fewer days of work.
However, more participants in the antibiotic group needed to visit an emergency room or urgent care clinic within three months, 9%, compared to the surgery group, 4%.
When surgery is successful, the appendix is completely removed, but with antibiotics, the appendicitis can return, and the researchers said they will determine how often this happens in follow-up reports.
For every 100 participants in the antibiotic group, there were about eight unexpected problems. In comparison, in the surgery group, there were four such problems.
The highest rate of problems in the antibiotic group was associated with participants with an appendicolith, which is a calcified deposit within the appendix. These participants had a higher rate of undergoing surgery within three months at 41% compared to the overall rate of the group of participants who used antibiotics of 29%.
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