October 26th, 2020

67% of 1078 children treated for appendicitis with antibiotics did not go on to need surgery according to a new study by Minneci and colleagues in JAMA.

Appendicitis patients choosing the non operative route received 24 hours of IV antibiotics in hospital followed by 6 days of oral antibiotics at home.

Why does this study matter?

1) the cost of the one hospitalization plus antibiotics will be far less than the surgical intervention

2) surgeries carry complication risks, albeit rare, that could be worse in the long run if the child has a bleeding issue, adhesion or perforation

3) anesthesia is not great for the young brain as many studies have identified

4) Losing the appendix takes away a repository of commensal intestinal microbes that puts one at risk for C. difficile colitis and other diarrheal illnesses

Dr. M

Minneci JAMA