Antibiotics have been proven effective enough so as to combat appendicitis, even in the absence of surgery, in a recent study published on Wednesday, December 16.
The findings, revealed in the journal JAMA Surgery, were based on an analysis led by Dr. Peter Minneci and Dr. Katherine Deans, both employed as pediatric experts at the Nationwide Children’s Hospital in Columbus, Ohio.
Appendix issues account for more than a tenth all the medical emergencies involving kids, and are more often than not triggered by bacterial infections, trauma or bowel disorders such as Crohn’s disease.
During their practice, the physicians had noticed that some kids scheduled for appendectomy (the procedure through which the vermiform appendix is removed) had experienced relief from their symptoms just by taking antibiotics.
Therefore, in order to test if surgery really is essential against appendix problems, a group of 102 patients, aged 7 to 17, were monitored by doctors, as part of a randomized controlled trial, carried out from October 2012 until March 2013.
All of the participants had developed a mild form of acute appendicitis: in other words, their appendix was still intact, albeit inflamed, and stomach pain had been in its early stages, having started less than 48 hours before.
While 65 of the kids received surgery, 37 were only treated with antibiotics, administered intravenously, for approximately 24 hours, and then orally for another 10 days.
It was determined that the vast majority of the patients included in the non-surgical group made a full recovery, their physical state taking a turn for the better following the very first day of antibiotic use.
Overall 95% of them were well enough to leave the hospital without having to receive an appendectomy, antimicrobial medicine therefore proving to be safe and effective.
When the kids from the antibiotics category were followed up 30 days after being released from the medical facility, it was determined that just 2 of them had required surgery, so as to extract their appendix after all.
Moreover, all things considered, the amount of medical assistance provided to subjects from both groups was estimated to be nearly the same, regardless of the type of treatment they had been assigned to initially (surgical or nonsurgical).
A year after the initial trial had ended, when monitoring participants once again, study authors discovered that more than three-quarters of those who had relied solely on medication against appendicitis had experienced no relapse, and there had been no need for them to have an appendectomy.
Based on these findings, study authors believe that surgery, which is often quite expensive and requires a longer period of rest and rehabilitation, should be reconsidered as the most obvious method of combating appendicitis.
Although it’s true that the surgical removal of the appendix neutralizes the possibility that this condition will ever re-emerge, positive results have also been identified when opting solely for antibiotics.
Therefore, some families whose children develop acute appendicitis may at least try to test this method of treatment first, before opting for surgery, which poses other concerns, such as those related to the use of anesthetics.
In response to these recent recommendations, other experts such as Dr. Terry Amaral, orthopedic surgeon at Cohen Children’s Medical Center, have warned that some cases of acute appendicitis may be too complex and severe so as to be cured solely with antibiotics.
In fact, delaying surgery when dealing with the approximately 70,000 new cases of appendicitis which appear on a yearly basis might turn out counter-productive or even dangerous at times.
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