Appendicitis: Antibiotics Treat


SEATTLE, Wash. (Ivanhoe Newswire)— About 300,000 Americans get their appendix removed each year due to illness. But a new study reveals there may be an alternative to going under the knife. Appendicitis

What if you had the option between having surgery or taking a pill to treat an illness?

“For me, the idea of not having to have myself cut open in any way shape or form is attractive,” shared patient advocate Bonnie Bizzell.

A new University of Washington study finds antibiotics may be an alternative for patients suffering from appendicitis. Historically, the first line of treatment has been surgery to remove the appendix. But …

“With COVID, it had really changed how healthcare systems were taking care of patients, and really wanting to minimize exposure,” explained Giana Davidson, MD, MPH, associate professor of surgery at the University of Washington School of Medicine.

When doctors compared patients who had an appendectomy right away versus those who took antibiotics, they found both groups had similar outcomes for length of time in the hospital and recovery 30 days out. Experts say this research provides patients with a choice when it comes to treatment.

“There are times in my life when having surgery would not have been a good option for me,” Bizzell recalled.

Dr. Davidson described, “We really had patients at the center, saying the things that were important to them to look for? Is it time off work, you need to be a caregiver, is it that you have finals coming up?”

But choosing antibiotics instead of surgery is not without risk. Some patients in the antibiotic group did have to return to the emergency room a few days later and three out of ten patients from the antibiotics group eventually went on to have an appendectomy within 90 days. But most recovered without surgery.

“I think that changes the whole experience,” Bizzell concluded.

Patients with a burst appendix were also included in the trial. Dr. Davidson says those patients don’t necessarily have to be rushed to surgery and may be treated with a ten-day course of antibiotics. But future research is needed to evaluate the risk factors.

Contributors to this news report include: Cyndy McGrath, Executive Producer; Milvionne Chery, Field Producer; Rusty Reed, Videographer; Roque Correa, Editor.

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REPORT:       MB #4876

BACKGROUND: The appendix is an organ the size of a finger-shaped pouch that protrudes from the colon in the lower right quadrant of the abdomen. Appendicitis occurs when the appendix becomes inflamed and causes severe pain in the lower right abdomen that typically increases. Most patients report pain beginning at the belly button and the moving to their side as the appendicitis progressed. Anyone is capable of developing appendicitis, it most often occurs in children as young as ten all the way to adults. Signs or symptoms of appendicitis include sudden abdominal pain, pain that worsens when coughing, walking, or making sudden movements, nausea and vomiting, loss of appetite, low-grade fever that may worsen, constipation or diarrhea and abdominal bloating. A blockage of the lining of the appendix resulting in infection is the most common cause of appendicitis. If appendicitis is not treated promptly the appendix will burst. A ruptured appendix spreads infection throughout your abdomen and can be life threatening.


TREATMENT: The traditional treatment for appendicitis, and other appendix-related issues, is appendectomy, or surgical removal of the appendix. There are two types of surgical procedures to remove the appendix, open or laparoscopic. The traditional method is open appendectomy, cutting a two-to-four-inch incision into the lower right abdomen and then removing the appendix through that incision. A newer, minimally invasive option is laparoscopic appendectomy where, instead of a large incision, one to three tiny cuts are made and a long thin tube called a laparoscope is put into one of the incisions, it has a tiny video camera and surgical tools that a surgeon can view and operate by looking at a monitor. The appendix is removed through one of these small incisions. During a laparoscopic surgery, surgeons still may decide that an open appendectomy is needed, especially if the appendix has burst and infection has spread.


NEW TECHNOLOGY: A new study looked at 250 adults in Finland who had appendicitis and were treated with antibiotics instead of surgery. This group was then compared to another group of 270 adults who had surgery for appendicitis. The study followed all participants for five years. By the end of the study, nearly two-thirds, or 64 percent, of the people in the antibiotic group

were considered “successfully treated,” meaning they didn’t have another appendicitis attack and their appendix did not burst. The other 36 percent in the antibiotic group eventually needed to have surgery to remove their appendix. However, these participants experienced no harmful outcomes due to the delay caused by antibiotic treatment. The antibiotic group also had much lower rates for complication and shorter recovery time when compared to those who had surgery, with most patients returning to work or school 11 days earlier than those not treated with antibiotics.






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Doctor Q and A

Read the entire Doctor Q&A for Giana Davidson, MD, MPH, associate professor of surgery

Read the entire Q&A