Acute appendicitis might be successfully treated with antibiotics without needing a surgery, according to report from Finnish researchers.
In some uncomplicated cases where the organ has not ruptured, appendicitis can be treated with antibiotics. However, a surgery may become necessary if it looks like the appendix may burst open immediately. The difference is easily seen on a CT scan, said lead researcher Dr. Paulina Salminen, a surgeon at Turku University Hospital.
“There are no severe complications associated with the antibiotic therapy, so it’s a safe option,” she said.
Salminen added that about 20 to 30 percent of patients with appendicitis have a punctured appendix that needs to be removed, but 70 to 80 percent of patients may only need antibiotics.
In a trial that compared 273 patients who had an appendectomy with 257 treated with antibiotics, researchers discovered that about 60 percent of those treated with antibiotics didn’t need to have their appendix removed in the five years after treatment.
About 100 of 257 patients treated with antibiotics had to have an appendectomy over the five years of the study, including 15 patients operated on during the initial hospitalization, the researchers found.
The report was published Sept. 25 in the Journal of the American Medical Association.
However, the merits and demerits of using antibiotics instead of surgery was pointed out by a U.S. expert, Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.
“I think the big issue is this — can physicians and patients accept the fact that there could be close to a 40 percent chance of recurrence in five years?” Glatter wondered, adding that it might not be acceptable for many people.
He emphasized that antibiotics may fail and require a surgery even though it may effectively treat acute appendicitis most time.
Glatter noted that the use of antibiotics is fast gaining popularity, though it requires further study in specific subgroups of patients who may be at higher risk, including patients with appendicolith, in which the appendix is obstructed with calcified deposits.
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