Antibiotics help some people avoid surgery for appendicitis

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In the journals

It is often assumed that appendicitis means automatic surgery to relieve the pain and avoid complications. Yet, a study published online Sept. 25, 2018, by JAMA found that many people with uncomplicated acute appendicitis may be safely treated with antibiotics and avoid an appendectomy.

About 70% to 80% of acute appendicitis cases are uncomplicated, which means the appendix hasn't ruptured or formed an abscess. In the study, researchers had 530 people with uncomplicated acute appendicitis either undergo an appendectomy or receive 10 days of antibiotic therapy. After five years, 61% of the antibiotic group had no recurrences of appendicitis and no appendectomies.

Those in the antibiotic group who did eventually require surgery often had it within a year after finishing the initial antibiotic treatment; however, they had fewer wound infections and less incision pain compared with those who had immediate surgery without any antibiotic treatment. These findings suggest that antibiotics to treat the infection and inflammation of acute appendicitis may be a more reasonable first step instead of immediate surgery.