Meta-analysis indicates initial treatment with antibiotics may reduce the need for appendectomy
FRIDAY, April 6 (HealthDay News) -- Although surgery is standard practice for treating appendicitis, uncomplicated acute appendicitis can be safely and effectively treated with antibiotics, according to a meta-analysis published online April 5 in BMJ.
Krishna K. Varadhan, from Queen's Medical Centre in Nottingham, U.K., and colleagues performed a meta-analysis of four randomized trials of 900 patients with uncomplicated acute appendicitis, where 470 were treated with antibiotics and 430 underwent appendectomy.
The researchers found that patients treated with antibiotics had a significantly lower risk of complications (risk ratio, 0.69), even after excluding patients who had crossed over between groups (risk ratio, 0.61). However, 20 percent of patients treated with antibiotics underwent appendectomy after readmission; of these, nine had perforated appendicitis and four had gangrenous appendicitis. The two groups had similar length of hospital stay, treatment efficacy, and risk of developing complicated appendicitis.
"Antibiotic treatment as the initial management of uncomplicated appendicitis is safe and effective," Varadhan and colleagues conclude. "Starting antibiotics when the diagnosis of uncomplicated acute appendicitis is made, with reassessment of the patient, will prevent the need for the most appendectomies, reducing patient morbidity."
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