Physicians Hall Front

Pediatric Appendicitis Study Shows Antibiotic Therapy Can Be as Effective as Surgery

Milwaukee, Wisconsin, Aug. 10, 2020 – Appendicitis is the most common reason for abdominal surgery, with more than 70,000 children in the United States undergoing appendectomy annually. Although most physicians treat appendicitis with a major intra-abdominal procedure, this procedure can lead to post-operative pain and disability for patients. Up to 15 percent of all appendectomy patients experience complications after their procedure, while up to 7 percent experience serious complications. The results of a study published recently in JAMA show that antibiotics alone can effectively treat uncomplicated appendicitis in children with a less negative impact on the patient and family.

This trial of more than 1,000 children in 10 hospitals across seven states was conducted by the Midwest Pediatric Surgery Consortium, a research collaborative conceived and executed by several surgical clinical investigators at major children’s hospitals throughout the region. Co-investigators of the trial at Children’s Wisconsin were Dave Lal, MD, MPH, professor of pediatric surgery, and Thomas Sato, senior associate dean and professor of pediatric surgery, at the Medical College of Wisconsin (MCW).

The researchers found that nonoperative management through antibiotics can effectively treat appendicitis in children and offer a preferred option for children and families, as it is less invasive and offers a more positive patient experience. This was measured through generalizable estimates of success rate, disability, health-related quality of life, medical/surgical complications and healthcare satisfaction.
Nonoperative management led to fewer disability days for the patient one year post operation, and healthcare satisfaction and satisfaction with decision scores were similar between families choosing surgery and families choosing nonoperative management. Taken together, these results support offering non-operative management as a treatment option for uncomplicated appendicitis.

“The risks and benefits of non-operative management with antibiotics alone and surgery are very different, therefore, a ‘successful’ treatment depends on which risks and benefits are most important to each patient and their family,” Dr. Sato said. “Our results support using an informed shared decision-making process to offer both surgery and non-operative management as treatment options for children with uncomplicated appendicitis.

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