A surgical procedure is by far the most common approach to treating appendicitis, however, it does not have to be according to a recently published appendicitis antibiotic treatment study conducted in the United Kingdom.
The researchers behind the study concluded that antibiotics may be effective in lieu of removing the appendix entirely, potentially eliminating the need for surgery altogether.
The appendix is similar to a small pouch and is shaped like a small finger. The appendix is located on the right side of the abdomen and is connected to the colon. In addition, to this day, medical experts are unsure of what the actual purpose of the appendix is. Appendicitis is defined as a condition in which the appendix becomes inflamed, swollen, and filled with fluid (pus).
31% Fewer Complications in Patients Receiving Antibiotics?
During the study, researchers from the U.K.’s University of Nottingham looked at four separate trials, each involving approximately 900 adults. All of the study participants had been previously diagnosed with uncomplicated acute appendicitis. The subjects were divided into two treatment groups, with 430 undergoing surgery and the remaining 470 receiving antibiotics.
The researchers determined that the individuals in the antibiotic treatment group were no more likely to have their appendix burst than those in the surgery treatment group. Further, those in the antibiotics group were 31% less at risk for dangerous complications such as infection, which makes sense given the relative evasiveness of surgery as compared to antibiotic treatment.
The researchers accounted for various factors, such as patients who started with antibiotics but still ultimately needed surgery down the road, and still noticed the risk reduction. Unfortunately, this scenario applied to about 20% of the subjects involved in the study, according to Dr. Olaf Bakker of the Netherlands’ University Medical Center Utrecht. Although Bakker was not directly involved with the study, he did author an accompanying editorial.
Appendectomy – an Outdated Procedure?
The researchers behind the U.K. study concluded that using antibiotics to treat acute, uncomplicated appendicitis may be just as effective as surgery. They believe that “most appendectomies” could be avoided simply by treating the patient with antibiotics and then reassessing them to determine whether the appendicitis has receded. In fact, the researchers said that the use of surgery as a first line of treatment for appendicitis may be based largely on tradition as opposed to real evidence.
Uncomplicated vs. Complicated Appendicitis
It should be noted that uncomplicated appendicitis differs from complicated appendicitis. In individuals with complicated appendicitis, either the abdominal cavity lining has become infected and swollen or the appendix itself has burst. Virtually all cases of complicated appendicitis still require surgery, according to the researchers.
Some Studies Disagree
Some studies suggest that using antibiotics instead of surgery to treat appendicitis may do more harm than good. The researchers behind these studies believe that in the absence of surgery, certain complications such as infection or perforation may arise. In light of these facts, surgery has remained the go-to treatment for appendicitis since the late 19th century.
However, the University of Nottingham researchers said their study agrees with a growing body of evidence suggesting that patients report fewer problems after having their appendicitis treated with antibiotics instead of surgery. Unfortunately, some of these studies have been retracted due to inconclusive results.
The only certainty is that more research remains before the medical community agrees upon the ideal treatment for appendicitis. Dr. Olaf Bakker said that surgery will continue to be the preferred method of treatment for the time being.
Appendicitis Antibiotic Treatment: The Bottom Line
A new study from researchers in the U.K. suggests that antibiotics may be just as effective as surgery in treating appendicitis, and result in a lower prevalence of complications as well.
However, more research and longer-term studies are needed before the findings can be considered conclusive. Patients may be able to receive antibiotics as a first line of treatment even in the current environment, so long as they’re closely monitored after.
The full text of the study can be found in the British Medical Journal.
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