THE QUESTION Appendicitis almost always prompts surgery to remove the organ. However, if the condition is considered uncomplicated, might treatment with antibiotics be a viable option that avoids the risks of an operation?
THIS STUDY analyzed data from four studies involving 900 adults with uncomplicated appendicitis who had been randomly assigned to an appendectomy or treatment with antibiotics. In the year following treatment, complications developed in 25 percent of those who had surgery, compared with 18 percent of those in the antibiotics group. About 20 percent of those initially given antibiotics were readmitted for an appendectomy. But
63 percent of those in the antibiotics group did not need surgery and had no recurrence of symptoms for at least a year.
WHO MAY BE AFFECTED? Adults with an inflamed appendix. Appendicitis can develop at any age, though it occurs most often in those in their teens and 20s. Attached to the colon, the appendix is a pouch that can become clogged, leading to swelling and infection and, sometimes, perforation. Complicated appendicitis — when there is serious infection or perforation — occurs about 20 percent of the time, but because the appendix has no discernible purpose, removing it has long been standard practice. However, modern techniques such as ultrasound and CT scans allow doctors to more accurately determine whether appendicitis is complicated or uncomplicated.
CAVEATS The studies included no participants younger than 18. Reported data did not indicate specific antibiotics but did note that some were given intravenously and some orally.
FIND THIS STUDY April 5 online issue of BMJ (www.bmj.com).
LEARN MORE ABOUT appendicitis at www.digestive.niddk.
nih.gov and www.mayoclinic.com.
— Linda Searing
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.