Are Antibiotics as Effective as Surgery for Appendicitis?

Antibiotics may be an effective alternative to surgery in cases of non-complicated appendicitis in children, says a review by researchers at Britain’s University of Southampton.

Appendicitis occurs when the appendix — a small organ attached to the large intestine —becomes inflamed due to infection or a blockage. It mainly affects children and teenagers, and it is currently treated by removing the appendix, known as an appendectomy.

Appendectomy is the most common cause of emergency surgery in children.

If appendicitis isn’t treated quickly, the appendix can rupture and cause a potentially deadly infection in the membrane lining the abdominal cavity.

Researchers assessed existing literature published over the past 10 years that included 10 studies reporting on children who received non-operative treatment — antibiotics — rather than an appendectomy. They found that no study reported any safety concern or specific adverse events related to non-surgical treatment, although the rate of recurrent appendicitis was 14 percent.

“Acute appendicitis is one of the most common general surgical emergencies worldwide and surgery has long been the gold standard of treatment,” said lead researcher Nigel Hall, Associate Professor of Pediatric Surgery at the University of Southampton. “But it is invasive and costly, not to mention extremely daunting for the child concerned and their family.

“Our review shows that antibiotics could be an alternative treatment method for children. When we compared the adult literature to the data in our review it suggested that antibiotic treatment of acute appendicitis is at least as effective in children as in adults. This now needs to be explored more widely.”

Scientists aren’t sure what role, if any, the appendix plays in the body, but recent research suggests it helps protect good bacteria in the gut. Nevertheless, it’s removal doesn’t appear to harm long-term health.

According to the New England Journal of Medicine, approximately 300,000 appendectomies are performed in the U.S. each year.

The review was published in the journal Pediatrics.