What is long-term risk of appendicitis reoccurring in patients treated with antibiotics?

Bottom Line: About 60 percent of patients with uncomplicated acute appendicitis who were initially treated with antibiotics did not undergo appendectomy in five years in a follow-up to a randomized clinical trial. The clinical trial included 273 patients who had an appendectomy and 257 patients initially treated with antibiotics for uncomplicated acute appendicitis. In all, 100 of 257 patients initially treated with antibiotics underwent appendectomy during the five-year course of this study, including 15 patients operated on during the initial hospitalization. The findings suggest antibiotics may be a feasible alternative to surgery for patients with uncomplicated acute appendicitis.

Authors: Paulina Salminen, M.D., Ph.D., Turku University Hospital, Turku, Finland, and coauthors

Related Material

The following related elements from the JAMA Network are also available on the For The Media website:

-- The editorial, "Antibiotic Treatment for Uncomplicated Appendicitis Really Works," by Edward H. Livingston, M.D., Deputy Editor, JAMA

-- A video abstract is available to embed on your website by copying and pasting the HTML code below. The transcript is available here. To download the video, email mediarelations@jamanetwork.org">mediarelations@jamanetwork.org for information.

-- A podcast interview with Paulina Salminen, M.D., will be posted on this page.

Previously published by the JAMA Network:

Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis - The APPAC Randomized Clinical Trial

Patient Preferences for Surgery or Antibiotics for the Treatment of Acute Appendicitis

Comparison of Antibiotic Therapy and Appendectomy for Acute Uncomplicated Appendicitis in Children - A Meta-analysis

Effectiveness of Patient Choice in Nonoperative vs Surgical Management of Pediatric Uncomplicated Acute Appendicitis

Antibiotics vs Surgery for Acute Appendicitis: Toward a Patient-Centered Treatment Approach

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To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.13201)

Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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