Appendicitis: antibiotics instead of surgery
Larissa Melville completed her traineeship in the editorial team of . After studying biology at Ludwig Maximilians University and the Technical University of Munich, she first got to know digital media online at Focus and then decided to learn medical journalism from scratch.
More about the experts All content is checked by medical journalists.MunichSevere pain in the right lower abdomen - if the appendix makes itself felt, an operation almost always follows. But not everyone has to go under the knife, because antibiotics can also help - at least for adults.
Appendicitis is not to be trifled with. If the intestine breaks through, life-threatening infections can result. So far, the surgeon has surgically removed the appendix immediately if an inflammation is suspected. The body usually gets along well with this, but like any procedure, this operation also involves certain risks. Paulina Salminen from Turku University Hospital and her colleagues therefore investigated whether antibiotics could stop the inflammation.
Acute but uncomplicated
The study examines the main form of appendicitis: acute uncomplicated appendicitis, which is present in 80 percent of cases. In contrast to the complicated form - which always requires an operation - there are no complications such as an intestinal perforation, tumors or foci of pus.
A total of 530 adults with acute uncomplicated appendicitis participated in the study. The diagnosis was made by the doctors using computed tomography. 273 of the study participants underwent the classic operation. 257 subjects took antibiotics for ten days. In the following year, the researchers regularly checked whether the inflammation in the antibiotic-treated patients had reignited and whether surgery was necessary.
Antibiotics work
The result: The antibiotic treatment was successful in 73 percent of the participants. The inflammation subsided and did not recur the following year. In 27 percent of the test subjects, the antibiotics were not sufficiently effective and the appendix had to be removed afterwards. “What is essential, however, is that these patients, despite the delayed intervention, did not have to struggle with more complications than those who were operated on straight away,” emphasizes Salminen. Preliminary treatment with antibiotics is a safe procedure for these patients too, adds the expert.
Many surgeries are avoidable
"We were able to show that many appendix operations and the associated risks could be avoided," summarizes Salminen. In addition, you save considerable costs. For a regular introduction of antibiotic treatment for uncomplicated appendicitis, however, further data are necessary. And its effectiveness in children in particular has yet to be investigated.
Appendicitis is when the finger-sized end of the large intestine, the appendix, becomes inflamed. In most cases, a blockage of the bowel precedes the inflammation. The bacteria contained in the feces get into the appendix, multiply and cause inflammation. Appendicitis can also be an accompanying symptom of a chronic inflammatory bowel disease such as Crohn's disease.
Sources:
Salminen P. et al .: Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis - The APPAC Randomized Clinical Trial. The Journal of the American medical Association (JAMA). doi: 10.1001 / jama.2015.6154.
Press release of the Hospital District of southwest Finland from June 16, 2015
Tags: skin care Baby Child parasites
