By Kelly Young
NEJM Journal Watch
Two thirds of youth who received antibiotics to treat uncomplicated appendicitis avoided surgery, according to a nonrandomized study in JAMA.
Researchers enrolled over 1000 children aged 7 to 17 who presented with uncomplicated appendicitis. Roughly 65% chose to undergo urgent laparoscopic appendectomy, while 35% chose nonoperative management with IV antibiotics in the hospital followed by oral antibiotics at home.
Nonoperative management was associated with a 67% success rate for avoiding surgery in the subsequent year. Of note, this did not meet the study surgeons’ threshold for success, which was 70%, but it did meet the target success rate of a team of families, primary care physicians, nurses, and others, who favored a 50% rate. The other primary outcome — the mean number of disability days at 1 year — was significantly lower in the antibiotics group (7 vs. 11 days).