Antibiotics could be alternative to surgery as treatment for appendicitis

By Dominic Kleinknecht

Eberhard-Karls-University Tübingen

A metastudy of researchers at the University of Southampton has shown that antibiotics, instead of surgery, may be an effective treatment for non-complicated appendicitis in children. The current, established gold standard to treat acute appendicitis, the surgical removal of the appendix, is costly, invasive, and extremely daunting for both the child in question and the children’s family compared to the alternative treatment with easy-to-use antibiotics. Having combed through data of 10 studies reporting on 413 children, the scientists concluded that there were no reports on any adverse effects or safety concerns when a non-operative treatment with antibiotics was chosen over an appendectomy, with the only downside being that there was a reported 14% rate of recurrent appendicitis. In order to access the longer term clinical outcomes and cost advantages of the antibiotic therapy, the review suggests further research with dedicated trials looking specifically into the outcomes of non-operative treatments since the research is still in its infancy. The first step in that direction has already been made with a year-long feasibility trial in order to determine how many patients would be willing to join a long-term study, and further trials in the planning stage.

 

Roxani Georgiou, Simon Eaton, Michael P. Stanton, Agostino Pierro, Nigel J. Hall. Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis. Pediatrics, 2017; e20163003 DOI: 10.1542/peds.2016-3003