Taking antibiotics would be enough to treat appendicitis in most patients, although for some the operation is unavoidable.
- This is the largest clinical trial ever conducted on treatments for appendicitis.
- The results indicate that antibiotics are most of the time the best treatment for appendicitis.
Should I operate on the appendix? World scientists seem to disagree on the answer. Last March, an Irish study supported the idea of surgery, estimating that this method offers a better quality of life to patients. New research, published October 25 in the New England Journal of Medicine, concludes otherwise. Carried out by American researchers from the Faculty of Medicine at the University of Washington, it claims that an intervention with antibiotics makes it possible to treat appendicitis without having to remove the appendix.
The antibiotic, the best treatment for a majority of patients
This is the largest clinical trial ever conducted on treatments for appendicitis. The results are from the CODA trial – for Comparing Outcomes of Antibiotic Drugs and Appendectomy. A total of 25 hospitals from 14 US states participated in this trial, involving 1,552 patients with appendicitis. It is a sudden pain that begins on the right side of their lower abdomen and is mostly felt by patients between the ages of 10 and 30. The pain will then increase as the inflammation gets worse. If the appendix ruptures, it can spread the infection throughout the abdomen, causing life-threatening complications.
The results indicate that antibiotics are most of the time the best treatment for appendicitis. “In the first three months after taking antibiotics for the disease, nearly 7 out of 10 patients in the antibiotic group avoided an appendectomysays Dr. David Flum, lead author of the study. After four years, just under 50% had undergone surgery. Other results favored either antibiotics or surgery. Overall, antibiotics seem to be the right treatment for many appendicitis patients, but probably not all.”
Two safe treatments
Treatment for appendicitis depends on the patient’s situation. “Although there were pros and cons for each treatment, we found that both treatments are safe and patients will likely rate these results differently based on their unique symptoms, concerns and circumstances.”, adds David Flum. So for people with appendicolite, a calcified deposit that doctors find in about a quarter of cases of acute appendicitis, the study finds that surgery is the best treatment, not least because there is is more likely that the antibiotics will not work.
“Given these results and new treatment guidelines, it is important for surgeons and patients to discuss the pros and cons of surgery and antibiotics to decide what treatment is best for that person at this time.”, concluded Dr. Giana Davidson, a professor of surgery and director of the clinical coordination center of the CODA trial.
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