antibiotics instead of surgery?

Severe pain, fevers and digestive problems: acute appendicitis is particularly painful. Every year, thousands of people have an appendectomy, or removal of the appendix, in France. According to the latest data from Health Insurance, 83,400 interventions were carried out in 2012. In The Lancetresearchers reveal that these operations could be replaced by antibiotic treatment, in certain cases.

A large study to compare the effects of antibiotics and surgery for appendicitis

This study was carried out by scientists from around the world: United States, Singapore, Canada, United Kingdom, Malaysia, Finland and Sweden. They recruited nearly 1,000 children, aged 5 to 16, all suffering from uncomplicated appendicitis. The latter term means that the appendix has not burst, a complication which can develop into peritonitis. “The study, known as the APPY study, is the first large-scale randomized pediatric trial of its kind“, specify the authors in a press release. Their objective was to compare the effects of antibiotic treatment in comparison to traditional appendectomy.

Appendicitis: antibiotics are less effective but more easily tolerated

This trial shows that antibiotic treatment is not as effective as surgery: there is a higher risk of treatment failure and recurrence. In the group of children treated with antibiotics, the failure rate was 34%, compared to 7% in the group of children who underwent surgery. No deaths or serious side effects were reported in either group. Although the effectiveness of antibiotic treatment is less than surgery, scientists believe that it is still a viable option. It must be considered after consulting the children and their parents. “One of the benefits of antibiotic treatment is that children can return to normal life more quickly.”they emphasize.

Antibiotics or appendectomy: other studies to evaluate their effectiveness

According to them, this work raises new questions. “There is still reason to believe that some children with appendicitis could be treated effectively with antibiotics and might not even require hospitalization.“, they suppose. Other studies are underway to evaluate whether treatment without antibiotics, based solely on pain management, could also be effective.