Oct. 5 (UPI) — Antibiotics and surgery are both good options for treating appendicitis, according to a study published Monday in the New England Journal of Medicine that found 7 in 10 patients treated with the drugs ultimately avoid surgery.
“About three in 10 patients in the antibiotic group ultimately underwent an appendectomy within 90 days,” study co-principal investigator Dr. David Flum said in a statement.
“There were advantages and disadvantages to each treatment, and patients will value these differently based on their unique characteristics, concerns, and perspectives,” said Flum, professor and associated chair of surgery at the University of Washington School of Medicine.
The Comparison of the Outcomes of antibiotic Drugs and Appendectomy is the largest study to date comparing antibiotics for appendicitis to appendectomy, which is a surgery to remove the appendix, researchers said.
The goal of the study is to help nearly 300,000 people who visit the hospital each year for appendicitis-related issues choose the treatment that would be best for them with support from the evidence in the study.
Inflammation of the appendix, usually occurring in the teens or 20s, is the most common cause of acute abdominal pain requiring surgery though some mild cases are treated with antibiotics alone.
The study involved 1,552 participants from 25 sites across 14 states, researchers said. One month after treatment, participants rated their general health as about the same in both groups.
In the antibiotics group, about 71% did not have surgery within three months, and participants in the antibiotic group missed missed about 3 1/2 fewer days of work.
However, more participants in the antibiotics group needed to visit an emergency room or urgent care clinic within three months, 9%, compared with the surgery group, at 4%.
When surgery is successful, the appendix is fully removed, but with the antibiotics, appendicitis can come back and researchers said they will determine how often that happens in follow-up reports.
For every 100 participants in the antibiotics group, there were about eight unexpected problems. By comparison, in the surgery group, there were about four such problems.
The higher rate of problems in the antibiotics group was related to participants with an appendicolith, which is a calcified deposit within the appendix. These participants had a higher rate of having surgery within three months at 41% compared to the overall group rate for participants using antibiotics of 29%.