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No More Appendectomies?

In some cases, antibiotics alone may be all that’s needed to address an inflamed appendix, a newly published study has shown. Researchers looked at substituting 24 hours of intravenous antibiotics in place of surgery for some children and teens. To qualify for the alternate protocol, the 77 youngsters who took part in the study had to have pain for 48 hours or less, exhibit only moderately elevated white blood counts, and completed a screening CT or ultrasound scans that clearly showed that the appendix hadn’t ruptured and the young patients had no impacted feces. Of the 77 patients who met the criteria, 30 decided to give the antibiotic route a try. Two of them needed surgery within 24 hours because they showed no signs of improvement on the drugs. Another youngster needed surgery later because of “insufficient improvement.” Under the usual protocol, appendicitis patients undergo immediate surgery. After 30 days, the 27 patients who received intensive antibiotics instead of surgery were doing well. The researchers wrote that they will continue to follow their young patients and provide information on the longer-term success rate, safety and cost-effectiveness.

Peter C. Minnici et al “Feasibility of a Nonoperative Management Strategy for Uncomplicated Acute Appendicitis in Children,” Journal of the American College of Surgeons,