A Finnish study published Tuesday in JAMA suggests that in most cases of uncomplicated appendicitis, patients can be treated with just antibiotics.
The study followed 530 patients between the ages of 18 and 60 who allowed researchers to decide their treatment of either antibiotics or surgery at random. The team found that three out of four patients who took antibiotics had an easy recovery, with the pain going away, and those who required surgery after antibiotics were not worse off for waiting. In an editorial accompanying the report, Dr. Edward H. Livingstone, surgeon and editor of JAMA who was not part of the research, wrote: "The time has come to consider abandoning routine appendectomy for patients with uncomplicated appendicitis.... So powerful is the perceived benefit of appendectomy for appendicitis that surgical treatment for appendicitis remains unquestioned, with seemingly little interest in studying the problem."
Antibiotics could only be used for patients with uncomplicated appendicitis, meaning they did not suffer from blockages or a perforated appendix. Every year, 300,000 Americans have surgery to treat appendicitis, and Livingstone has concluded that people with uncomplicated appendicitis appear to have a different disease that can be treated with antibiotics. The Finnish team is now planning a clinical trial to test the theory that antibiotics aren’t always necessary, and it could be possibly that most people suffering from appendicitis can get better without any medical intervention.
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