Antibiotics may reduce appendicitis surgeries: study

Using antibiotics as the primary treatment for mild appendicitis does not increase the risk for complications at least in the first year and can reduce the number of surgeries by 92 per cent within the first month of diagnosis, a new study has claimed.
Surgery has been the standard treatment for appendicitis for more than a century. Studies have been carried out over the years to determine whether non-perforated appendicitis could be treated with antibiotics instead, but despite research results suggesting this, the choice of treatment remains largely unchanged, scientists said.
An international collaboration group, including researchers from the University of Helsinki in Finland and McMaster University in Canada, analysed five randomised controlled trials comparing the use of antibiotics and appendectomy to treat appendicitis.

The trials included in the meta-analysis encompassed a total of 1,116 patients.
According to the meta-analysis, roughly the same number of serious complications were found in the two groups - in 5 per cent of the cases in the antibiotics group and 8 per cent in the appendectomy group.
In the antibiotics group, 8 per cent of the patients underwent an appendectomy within one month, and appendicitis recurred in 23 per cent of the cases during the twelve-month follow-up.

"Used as the primary treatment, antibiotics reduced the number of surgeries by 92 per cent within the first month of diagnosis," said Kari Tikkinen from Helsinki University Hospital.

"This choice of treatment meant that appendicitis recurred in 23 out of 100 patients within one year. Moreover, no long-term follow-up exists for now," said Tikkinen.
Antibiotics can be used as the first-stage treatment for mild appendicitis, but that it is unclear how many of those treated with antibiotiocs first avoid surgery in the long term, researchers said.
"A diagnosis must always be made in emergency surgical care. The treatment must not be chosen based on suspicion alone," said Ville Sallinen from Helsinki University Hospital.
The findings were published in the British Journal of Surgery.