Most appendicitis patients can have antibiotics as their first treatment

Editor's Note

About half of patients with appendicitis do not need an appendectomy for up to 4 years after receiving antibiotics, finds this study presented October 25 at the American College of Surgeons virtual Clinical Congress 2021.

The study was conducted at 25 US medical centers in 1,552 adults with appendicitis who were randomly assigned to receive antibiotics or an appendectomy.

Appendectomy rates in the antibiotics group were 40% at 1 year, 46% at 2 years, and 49% at 3 and 4 years after antibiotic therapy.

A predictor of antibiotic-treated patients having an appendectomy was the presence in the first 48 hours of an appendicolith (ie, a small stone in the appendix). After 30 days, that risk decreased.

Complications were uncommon in both groups after the first month.

To help patients make a treatment decision, the researchers developed an online decision-making tool, available at: https://uwb.qualtrics.com/jfe/form/SV_beimLPK3ROzXSui.

The results show the safety and sustainability of another treatment for appendicitis besides surgical removal of the appendix, the researchers say.