A large Finnish study provides the best evidence to date that most patients with appendicitis can be treated with antibiotics alone.
The study involved 530 patients aged 18 to 60 who were randomly assigned to surgery or antibiotics. Results showed that three out of four who took antibiotics recovered easily. The results only apply to uncomplicated appendicitis, stressed Dr. Paulina Salminen, a surgeon at Turku University Hospital in Finland and lead author.
"The time has come to consider abandoning routine appendectomy for patients with uncomplicated appendicitis," said Dr. Edward H. Livingston, a surgeon and editor at the journal.
In the 1950s, soon after antibiotics were discovered, some doctors reported success using them to treat patients with appendicitis. But, Dr. Livingston wrote in his editorial, "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."
"Obviously, you can treat appendicitis with an antibiotic," said Dr. David Flum, a surgeon at the University of Washington who will be a principal investigator in that study. "But from a patient's point of view, should you?"