Antibiotics could be alternative to surgery as treatment for appendicitis

February 17, 2017, University of Southampton

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

Baby brains help infants figure it out before they try it out

January 17, 2018
Babies often amaze their parents when they seemingly learn new skills overnight—how to walk, for example. But their brains were probably prepping for those tasks long before their first steps occurred, according to researchers.

NeuroNext biomarker study explores natural history of infantile-onset SMA

January 9, 2018
Research led by The Ohio State University Wexner Medical Center to define the natural history of infantile-onset spinal muscular atrophy (SMA) has been "critical" to accelerate the development of effective therapies and hasten ...

No link between childhood lead levels, later criminality

December 27, 2017
(HealthDay)— Exposure to higher levels of lead during early childhood can affect neurological development—but does that mean affected kids are doomed to delinquency?

Early puberty in girls may take mental health toll

December 26, 2017
(HealthDay)—A girl who gets her first menstrual period early in life—possibly as young as 7—has a greater risk for developing depression and antisocial behaviors that last at least into her 20s, a new study suggests.

Technology not taking over children's lives despite screen-time increase

December 21, 2017
With children spending increasing amounts of time on screen-based devices, there is a common perception that technology is taking over their lives, to the detriment and exclusion of other activities. However, new Oxford University ...

Higher blood sugar in early pregnancy raises baby's heart-defect risk

December 15, 2017
Higher blood sugar early in pregnancy raises the baby's risk of a congenital heart defect, even among mothers who do not have diabetes, according to a study led by researchers at the Stanford University School of Medicine.

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.