Appendix surgery not needed for all patients

Using antibiotics instead of surgery for some patients with appendicitis may be a safe and effective first line treatment, a UK study suggests. Since 1889 doctors have used the surgical removal of the appendix or appendectomy as the only effective treatment for acute inflammation of the appendix, a blind-ended pouch attached to the beginning of the large intestine. After reanalyzing data of four prior studies, researchers at the University of Nottingham concluded that standard antibiotic regimes may work enough for many patients with uncomplicated appendicitis. During the trials which involved 900 adult patients with uncomplicated acute appendicitis, 470 cases received antibiotics and 430 had surgery. The results showed that 63 percent of the antibiotic group were symptom-free after a year and avoided appendectomy. They also had a 31 percent lower risk of complications compared with those who underwent appendectomy. About 20 percent of patients who were treated with antibiotics were eventually readmitted to the hospital with recurring symptoms while only 13 percent eventually faced complications which ended to the surgery. Three of the patients were successfully treated with another round of antibiotics, and four had a normal appendix, reported Dileep N. Lobo and colleagues. “The role of antibiotic treatment in acute, uncomplicated appendicitis may have been overlooked mainly on the basis of tradition, rather than evidence,” researchers wrote in the BMJ (British Medical Journal). The team, however, emphasized that patients with complicated appendicitis in which the appendix has burst, or the lining of the abdominal cavity is swollen and infected should still be treated with surgery.