To treat appendicitis, we have found an alternative to the operation

For children, the attack of appendicitis is often synonymous with the first pass on the pool table. Yet according to a new study, some can be treated with antibiotics without surgery. We are talking about appendicitis attacks treated at the start of the infection.

The researchers aimed to “determine the rate of late recurrence of appendicitis after antibiotic therapy for the treatment of acute uncomplicated appendicitis.” To do this, 530 Finnish patients (201 women; 329 men) aged 18 to 60, all suffering from an attack of appendicitis, were divided into two groups. The limbs of the first had appendicitis removed (273), the patients of the second received antibiotic treatment (257).

Recidivism

Antibiotic therapy was given with intravenous ertapenem for 3 days, followed by 7 days of oral levofloxacin and metronidazole. In addition to the 70 patients who initially ingested antibiotics but underwent appendectomy within the first year of treatment, 30 other antibiotic-treated patients underwent appendectomy between 1 and 5 years after the attack. The incidence of appendicitis recurrence was 34% after 2 years, 35.2% after 3 years, 37.1% after 4 years and 39.1% after 5 years.

Significant difference in sick leave

Of the 85 patients in the antibiotic group who subsequently underwent appendectomy, 76 had uncomplicated appendicitis, 2 had complicated appendicitis, and 7 had no appendicitis at all. After 5 years, the overall complication rate was 24.4% in the “appendectomy group” and 6.5% in the “antibiotics group”. There was no difference between the groups in the length of hospital stay, but there was a significant difference in sick leave (11 more days for the appendectomy group).

“The short-term results support the use of antibiotics as an alternative to surgery for the treatment of acute uncomplicated appendicitis,” the scientists conclude. They warn, however, that “long-term results are not known.”

The number of appendectomies decreases

Acute appendicitis is a sudden inflammation of a diverticulum in the right colon called the appendix. It is due to its obstruction, especially by feces. Occurring especially in young people under 20, it causes severe pain in the lower abdomen, on the right.

In France, the frequency of surgical interventions for appendicitis remains high. In 2009, the country was, in decreasing order of intervention, eighth of the 22 countries of the European Union. However, the number of appendectomies on French territory has fallen sharply in recent years.