Antibiotics for appendicitis -- yes and no

http://www.eurekalert.org/pub_releases/2016-03/uoh-afa031816.php

PUBLIC RELEASE: 18-MAR-2016
Antibiotics for appendicitis -- yes and no
UNIVERSITY OF HELSINKI

Surgery has been the standard treatment for appendicitis for more than a century. Millions of appendectomies are performed annually in the world, more than 300,000 in the US alone. Studies have been carried out over the years to determine whether non-perforated appendicitis could be treated with antibiotics instead, but despite research results suggesting this, the choice of treatment remains largely unchanged.

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According to the meta-analysis, roughly the same number of serious complications were found in the two groups: in 5% of the cases in the antibiotics group and 8% in the appendectomy group (pooled risk difference: -3%). In the antibiotics group, 8% of the patients underwent an appendectomy within one month, and appendicitis recurred in 23% of the cases during the twelve-month follow-up.

"The studies did not provide a high quality evidence for complications, but according to best evidence available, using antibiotics as the primary treatment for mild appendicitis does not lead to more complications in the first twelve months of follow-up," summarises consultant gastrointestinal surgeon Ville Sallinen.

"Used as the primary treatment, antibiotics reduced the number of surgeries by 92% within the first month of diagnosis," says adjunct professor Kari Tikkinen. "However, this choice of treatment meant that appendicitis recurred in 23 out of 100 patients within one year. Moreover, no long-term follow-up exists for now."

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