Antibiotics could be alternative to surgery as treatment for appendicitis

February 17, 2017

A study by researchers at the University of Southampton shows that antibiotics may be an effective treatment for acute non-complicated appendicitis in children, instead of surgery.

The systematic review of existing literature is published in Pediatrics.

The condition, which causes the appendix—a small organ attached to the large intestine—to become inflamed due to a blockage or infection, affects mainly children and teenagers. Appendicitis is currently treated through an operation to remove the appendix, known as an appendicectomy, and it is the most common cause of emergency surgery in children.

The review, led by Nigel Hall, Associate Professor of Paediatric Surgery at the University of Southampton, assessed existing literature published over the past 10 years that included 10 studies reporting on 413 children who received non-operative rather than an appendectomy.

It shows that no study reported any safety concern or specific adverse events related to non-surgical treatment, although the rate of recurrent appendicitis was 14 per cent.

Mr Hall, who is also a Consultant Paediatric and Neonatal Surgeon at Southampton Children's Hospital, commented: "Acute appendicitis is one of the most common general surgical emergencies worldwide and surgery has long been the gold standard of treatment. But it is invasive and costly, not to mention extremely daunting for the child concerned and their family. Our review shows that antibiotics could be an alternative treatment method for children. When we compared the adult literature to the data in our review it suggested that antibiotic treatment of is at least as effective in children as in adults. This now needs to be explored more widely."

The review says that longer term clinical outcomes and cost effectiveness of antibiotics compared to appendicectomy require further evaluation, preferably as large randomised trials to reliably inform decision making.

To further this research Mr Hall and his team in Southampton, along with colleagues at St George's Hospital in Tooting, Alder Hey Children's Hospital in Liverpool and Great Ormond Street Hospital, are currently carrying out a year-long feasibility trial which will see children with randomly allocated to have either surgery or antibiotic treatment.

Mr Hall said: "In our initial trial, we will see how many patients and families are willing to join the study and will look at how well children in the study recover.

"This will give us an indication of how many we may be able to recruit into a future larger trial and how the outcomes of non-operative treatment compare with an operation."

Explore further: Fewer antibiotics, better outcomes for complicated appendectomy patients?

More information: Efficacy and Safety of Non-Operative Treatment for Acute Uncomplicated Appendicitis: A Meta Analysis, March 2017, Pediatrics (published online on Friday 17 February).

Related Stories

Fewer antibiotics, better outcomes for complicated appendectomy patients?

October 26, 2015
With acute appendicitis ranking among the nation's most common acute surgical emergencies, researchers studied the relatively routine use of post-operative antibiotics in complicated cases and found that they didn't reduce ...

Trial compares antibiotics vs. appendectomy for treatment of appendicitis

June 16, 2015
Among patients with uncomplicated appendicitis, antibiotic treatment did not meet a prespecified level of effectiveness compared with appendectomy, although most patients who received antibiotic therapy did not require an ...

Antibiotics a safe and viable alternative to surgery for uncomplicated appendicitis, say experts

April 5, 2012
Giving antibiotics to patients with acute uncomplicated appendicitis is a safe and viable alternative to surgery, say experts in a study published in the British Medical Journal today.

Antibiotics alone can be a safe, effective treatment for children with appendicitis

December 16, 2015
Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family. A study led by researchers at Nationwide Children's Hospital found that three ...

Treating acute appendicitis with antibiotics not as effective as having appendix removed

May 5, 2011
Treating acute appendicitis with antibiotics is not as effective as the gold standard treatment of having the appendix surgically removed (appendicectomy). This is the conclusion of an Article in this week's edition of The ...

Antibiotics could replace surgery for appendicitis

September 26, 2012
Although the standard approach to acute appendicitis is to remove the appendix, a study at the Sahlgrenska Academy, University of Gothenburg, Sweden, reveals that treatment with antibiotics can be just as effective in many ...

Recommended for you

Study shows probiotics can prevent sepsis in infants

August 17, 2017
A research team at the University of Nebraska Medical Center College of Public Health has determined that a special mixture of good bacteria in the body reduced the incidence of sepsis in infants in India by 40 percent at ...

Smoking raises risk of aneurysm recurrence after endovascular treatment

August 17, 2017
In a new study, researchers report people who have experienced an aneurysm have another reason to quit smoking.

Children who sleep an hour less at higher risk of type 2 diabetes, says study

August 15, 2017
A study has found that children who slept on average one hour less a night had higher risk factors for type 2 diabetes, including higher levels of blood glucose and insulin resistance.

Low blood sugars in newborns linked to later difficulties

August 8, 2017
A newborn condition affecting one in six babies has been linked to impairment in some high-level brain functions that shows up by age 4.5 years.

Can breast milk feed a love of vegetables?

August 4, 2017
(HealthDay)—Want your preschooler to eat veggies without a fuss? Try eating veggies while you're breast-feeding.

Study adds to evidence that most prescribed opioid pills go unused

August 2, 2017
In a review of half a dozen published studies in which patients self-reported use of opioids prescribed to them after surgery, researchers at Johns Hopkins report that a substantial majority of patients used only some or ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.