Antibiotics instead of surgery for appendicitis in children

Children rushed to hospitals with appendicitis are routinely treated surgically. But a new study indicates that many of them may be able to avoid going under the knife -- or more accurately, the laparoscope -- and be treated with antibiotics instead.

Researchers from Nationwide Children's Hospital in Columbus, Ohio, offered a choice of surgery or antibiotics to 77 patients with uncomplicated cases of appendicitis over the course of a year. Thirty chose to address the infection with the medication, rather than the traditional surgical procedure. Physicians were able to eliminate the problem in 27 of them, with no recurrence after 30 days.

The study was published online April 12 in the Journal of the American College of Surgeons.

Appendicitis is the most common condition leading to emergency surgery in children. The appendix, a thin, small tube located where the large and small intestines meet, can become infected and inflamed sometimes when blocked by small pieces of stool. The infection can cause intense pain and, if the appendix ruptures, can lead to widespread infection.

When compared to the group that underwent surgery, the group treated with antibiotics had fewer disability days (3 vs. 17) , and returned to school in an average of three days instead of five. Parents and children had higher "quality of life scores," but the children treated with antibiotics spent more time in the hospital (38 hours vs. 20 hours).

The researchers said more study is needed to determine the longer-term success rate, safety and cost-effectiveness of the use of antibiotics.

Lenny Bernstein writes the To Your Health blog. He started as an editor on the Post’s National Desk in 2000 and has worked in Metro and Sports.
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Lenny Bernstein · April 25