Antibiotics Can be First-Line Therapy for Uncomplicated Appendicitis Cases
upstart writes:
With numerous recent studies demonstrating that antibiotics work as well as surgery for most uncomplicated appendicitis cases, the non-surgical approach can now be considered a routine option, according to a review article in JAMA.
The finding -- appearing Dec. 14 and led by Theodore Pappas, M.D., professor in the Department of Surgery at Duke University School of Medicine -- cites the consensus of evidence that antibiotics successfully treat up to 70% of appendicitis cases. Surgery, usually done laparoscopically, remains the definitive option for otherwise healthy patients with a severely inflamed appendix or other factors that increase the risk of rupture.
"Acute appendicitis is the most common abdominal surgical emergency in the world, striking about one in 1,000 adults," Pappas said. "Until recently, the only treatment option was surgery, so having a non-surgical approach for many of these cases has significant impact for both patients and the health care system."
Pappas said the criteria for determining the best treatment approach is nuanced, but not excessively difficult. Appendicitis cases -- marked by abdominal pain that often migrates to the lower right side, nausea and vomiting, and low-grade fever -- are confirmed with ultrasound and/or CT scans.
If the scans depict no complications, most of these patients could receive antibiotics instead of undergoing an appendectomy. Antibiotics could also be a first-line therapy for patients who have severe symptoms, but who are older or have medical conditions that add risks to surgeries.
Journal Reference:
Dimitrios Moris, Erik Karl Paulson, Theodore N. Pappas. Diagnosis and Management of Acute Appendicitis, JAMA (DOI: 10.1001/jama.2021.20502)
Read more of this story at SoylentNews.