For
people suffering from uncomplicated appendicitis, a course
of antibiotics may be just as good as having the appendix
removed, British researchers report. The researchers
reviewed studies involving hundreds of patients to determine
that treatment with antibiotics could be a safe alternative
to surgery, which has been the so-called "gold standard" of
care for an inflamed appendix since 1889. Starting
antibiotics when the diagnosis of uncomplicated acute
appendicitis is made will prevent the need for most
appendectomies, reducing patient morbidity, researcher said.
Since better diagnostic tools are now available to diagnose
appendicitis, it is safe to adopt a careful ‘wait, watch and
treat’ policy for those who have uncomplicated appendicitis.
A meta-analysis of four studies in which a total of 900
patients with appendicitis were randomly assigned to surgery
or antibiotics. Among patients treated with antibiotics, 63
percent did not need any further treatment after a year. In
addition, antibiotic use resulted in 31 percent fewer
complications than surgery, the researchers found. Among the
more than 400 patients treated with antibiotics, 68 had
recurrent symptoms. Of those, 13 had serious appendicitis,
04 had a normal appendix and 03 were successfully treated
with antibiotics, investigators noted. The researchers also
found no real differences in the length of hospital stays or
the risk of complicated appendicitis between people treated
with antibiotics and those who underwent surgery. Patients
must be willing to accept an initial failure and subsequent
recurrence rate of about 40 percent in exchange for the
possibility of foregoing surgery and its associated risks.
However, appendectomy does not have a lot of complications,
while the researchers found that antibiotic treatment
resulted in a 20 percent chance of recurrence (with a
perforated or gangrenous appendix) within a year. These
results therefore should be interpreted with caution.
Further studies are needed regarding this. The best for a
patient can done is making an informed choice by asking
questions. |