A new Finnish study published in the Journal of the American Medical Association suggests that, for patients with “uncomplicated appendicitis,” the best treatment might not be an appendectomy, but rather antibiotics alone.
You can read an article on the study findings here:
[Study supports antibiotics — not surgery — to treat appendicitis](http://www.seattletimes.com/nation-world/study-supports-antibiotics-to-treat-appendicitis/)
For decades, the standard of care for treating a patient with appendicitis was an appendectomy – removal of the appendix. This new study seems to suggest that, at least with some patients, surgery is unnecessary.
The results of the study are not without question marks. First, complicated cases of appendicitis, including perforated appendixes or abscesses, should still be treated surgically. Second, the study used a significant amount of antibiotics: three days of IV drugs in a hospital, followed by a week of pills at home. Even with that amount, which the study’s author conceded was probably excessive, antibiotic treatment failed with more than 25% of the patients.
And, while surgery certainly carries risks and downsides – particularly with respect to post-surgical infections – once the appendix is removed, the problem is solved. Treating appendicitis with antibiotics alone carries the risk of another bout of it in the future, and patients who have already had appendicitis once are more likely to suffer from it in the future.
Considering all these questions, an American group that includes a surgeon from the University of Washington is planning a similar clinical trial, but comparing the outcomes of laparoscopic surgery patients and a less powerful antibiotic regimen.
Appendicitis is a not uncommon condition, and one that can result in a medical negligence claim if not properly diagnosed and timely treated. Now, the standard of care is to remove the appendix. Failing to timely do so in the face of signs and symptoms consistent with appendicitis is negligent.
However, in the future, if the standard of care evolves to consider antibiotics alone as an appropriate method of treating the disease, a clinician can rely on his or her clinical judgment in defending the choice of treatment.
