In case of appendicitis, antibiotics are a real alternative to surgery

Instead of operating on patients with appendicitis, it is possible to treat them with antibiotics. According to the results of a study comparing the two techniques, people treated with drugs recover well, in the long term.

A follow-up that extends over more than twenty years

For this work, the scientists analyzed the data of 260 patients with appendicitis, treated by operation or by antibiotics between 1992 and 1996. Some were followed up to 26 years after their initial treatment.

None of the patients chose one treatment over the other. Treatment decisions were made randomly at the time, with half the patients undergoing surgery and the other half receiving antibiotic treatment alone.

30% of patients on antibiotics alone end up having surgery

Only one out of 10 patients having been treated with antibiotics had recourse to care for abdominal pain, over this follow-up period, compared to patients having been operated on.

Only 15% of them ended up being operated on for an appendectomy, while they were hospitalized. And 30% were at some point during this follow-up.

Which means that 70% of them did not need surgery. “We were reassured to see that only a few patients had their appendix removed after the first year, and we saw no evidence of other harm.” says Simon Eaton, Senior Lecturer in Pediatric Surgery and Metabolic Biochemistry at the Great Ormond Street Institute of Child Health at University College London, UK.

“No option is the best”

Those in the “antibiotics” group also did not appear to face a higher risk of inflammatory bowel disease, compared to the surgical group.

“Neither option is “best”. But we are now able to tell a patient who has appendicitis that if treated non-operatively they have a greater than 50% chance of never needing an operation. So we think there are now two treatment options for appendicitis“concludes the author of the study.