Antibiotic management is effective for uncomplicated appendicitis

Surgery may not be necessary for children with uncomplicated appendicitis, study shows.

Surgery may not be necessary for children with uncomplicated appendicitis. In the picture, a doctor examining a boy's abdomen.

Studies have shown that non-operative management of uncomplicated appendicitis with antibiotics is effective in children and adults. But these studies did not consider the preferences of patients or their families, which may affect outcomes. 

A study conducted at the Nationwide Children’s Hospital in Ohio gave parents the choice of appendectomy (n=65) or non-operative management (n=37) for children with uncomplicated appendicitis. 

The non-operative strategy involved a minimum 24 hours of inpatient observation with IV antibiotics and a ten-day course of oral antibiotics. After one year, three-quarters of these patients were able to avoid surgery. Additionally, these children had fewer disability days (median 8 vs 21) and lower appendicitis-related healthcare costs (median US$4,219 [£3,000] vs US$5,029 [£4,000]). 

When chosen by the family, non-operative management is effective for uncomplicated appendicitis, conclude the researchers in JAMA Surgery (online, 16 December 2015)[1]


[1] Minneci PC, Mahida JB, Lodwick DL et al. Effectiveness of patient choice in nonoperative vs surgical management of pediatric uncomplicated acute appendicitis. JAMA Surgery 2015. doi:10.1001/jamasurg.2015.4534.

Last updated
Clinical Pharmacist, CP, January 2016, Vol 8, No 1;8(1):DOI:10.1211/PJ.2015.20200339

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