Antibiotics could be alternative to surgery as treatment for appendicitis

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A systematic review of available evidence compares efficacy and safety.

A systematic review of existing evidence has concluded that antibiotics may be an effective alternative to surgery in children with acute non-complicated appendicitis.

The review, published in Pediatrics , identified 10 relevant studies published over the past 10 years which reported on 413 children who received non-operative treatment rather than an appendectomy. It found that no study reported any safety concern or specific adverse events related to non-surgical treatment. Antibiotic treatment was effective as the initial treatment in 97 per cent of children but the rate of recurrent appendicitis was 14 per cent. Complications and total length of hospital stay during follow-up were similar among children treated with antibiotics and surgery, but initial length of hospital stay was marginally longer in children treated with antibiotics.

Longer term clinical outcomes and cost effectiveness of antibiotics compared to appendicectomy require further evaluation. To advance the research, a collaborative project between four UK hospitals is currently carrying out a year-long feasibility trial which will see children with appendicitis randomly allocated to either surgery or antibiotic treatment.

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