A research report that 'no longer appendicitis can be treated with antibiotics without surgery'

by Global Panorama

Appendicitis is a state in which bacteria proliferate and cause inflammation in the " appendix " which is a part of the large intestine. If appendicitis is left untreated, the proliferation of bacteria will proceed, causing peritonitis and life threatening as well. Therefore, the surgical operation that promptly resects the appendix itself is the mainstream of appendicitis treatment, but the experimental results that "administration of antibiotics" should be reviewed as a sufficiently effective treatment method have been announced.

Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial | Emergency Medicine | JAMA | JAMA Network
https://jamanetwork.com/journals/jama/article-abstract/2703354

After century of removing appendixes, docs find antibiotics can be enough | Ars Technica
https://arstechnica.com/science/2018/09/after-century-of-removing-appendixes-docs-find-antibiotics-can-be-enough/

In the treatment of appendicitis, surgical treatment such as appendix and resection of the cecum is mainly performed. In the past, laparotomy was mainstream, but in the modern era when technology was developed, there are an increasing number of cases where possible laparoscopic surgery is performed simply by opening a few small holes in the abdomen.

On the other hand, appendicitis is caused by the growth of bacteria, administration of antibiotics is also one treatment. However, as the possibility of relapse is high, treatment with only antibiotic administration was limited to appendicitis at a relatively early stage. However, there was no long-term study on how much the recurrence rate of antibiotic administration is high.

Paulina Salminen, who works for Turku University Hospital in Finland, said, "Now that antibiotics are also more effective, we now have more accurate diagnosis by CT scan etc., so we are going to use the treatment of appendicitis, the first surgical operation We should review it. " In order to investigate "recurrence rate of appendicitis when antibiotic medication therapy was performed for a long time", clinical trials of 530 years of appendicitis treatment were conducted for 530 patients aged 18 to 60 years.

In clinical trials, 273 out of 530 people underwent appendectomy and 257 others had antibiotic infusion and oral antibiotics. As a result, it was found that the cumulative incidence of appendicitis recurrence in patients treated with antibiotic administration was 39.1% over 5 years. In other words, about 60% of patients treated with antibiotic treatment were able to cure appendicitis without surgery. Also, while patients who received antibiotics had a complication rate of only 6.5%, patients who underwent surgery resected the appendix themselves, so there is no recurrence, but 24% He complained that he caused complications.

by Vic

In addition, it was found that the disease vacation of patients who received antibiotics was around 11 days, whereas the disease vacation of patients who underwent open surgery was found to be around 22 days, It is reported that there is a possibility that it can be shortened.

From this, the research team led by Salminen argues that administration of antibiotics is a sufficiently effective therapy for appendicitis as well as surgery. However, in this study, we have not investigated the balance of medical expenses and insurance with surgical operation and antibiotic medication therapy. In order to evaluate antibiotic drug therapy as a treatment for appendicitis, research on system aspects is also a future task.