Once, appendicitis in a child always meant immediate surgery. But a new study has found that antibiotics may work just as well for children with uncomplicated appendicitis. (That means no ruptured appendix, a relatively low white blood count and no impacted feces.)
The study, in JAMA Surgery, enrolled 102 children aged 9 to 13 years old who had acute appendicitis. Sixty-five families chose appendectomy, and 37 chose management with antibiotics. By 21 months after the initial diagnosis, less than a quarter of the children treated only with antibiotics had had to have an appendectomy.
There were no significant differences between the two groups in incidents of complicated appendicitis or self-reported quality of life, and the cost of nonoperative management was 16 percent lower than surgery.
The surgery group had more complications and two of those who chose antibiotics had to be readmitted to the hospital for appendectomies in the first 30 days.
“We offer a choice,” said the senior author, Dr. Katherine J. Deans, an assistant professor of surgery at Nationwide Children’s Hospital. “With antibiotics, the pain’s gone almost immediately. But some don’t want to risk having the pain come back, and for them the best option is to choose surgery. Both are safe. Both are reasonable.”