Researchers Find Antibiotics Can Be A First-Line Treatment For Many Patients Facing Appendectomy

MIAMI (CBSMiami) – Appendectomy for appendicitis is the most common emergency surgical procedure in the United States. Now there's mounting evidence some patients can avoid or delay removing the appendix and receive treatment with antibiotics instead.

Five years ago, Heather VanDusen ended up in the emergency room at University of Washington Medical Center.

"I was in really terrible pain, more pain than I had ever really felt with stomach issues before. So much so that I wanted to vomit," VanDusen said.

The diagnosis was appendicitis, which typically meant urgent surgery to remove the infected or inflamed appendix.

Now the latest research has led the American College of Surgeons to say antibiotics can be a first-line treatment for many patients.

"If you have appendicitis and present to the emergency department, you have treatment options from surgery or antibiotics," said Dr. Giana Davidson, an associate professor of surgery at UW Medicine.

Davidson is a co-author on the largest ever randomized clinical trial of appendicitis treatment.

Over 1,500 patients received either an appendectomy or antibiotics. In the first three months, nearly seven in 10 patients in the antibiotic group avoided surgery. Four years out, just under half of patients in the antibiotic group had surgery.

Researchers have created an online tool to help patients and surgeons discuss the pros and cons of each approach based on the current data.

"We're hoping that helps empower people to have discussions with their surgeons about the treatment option that makes the most sense for them at that moment," Davidson said.

VanDusen chose antibiotics over an appendectomy.

"They didn't make me feel the greatest. I was really tired. I had like a weird metallic taste," she said. "But after I finished the course of antibiotics, my life went back to normal. I have never I have not had another episode."

She avoided surgery and is grateful she was able to make an informed decision about her health.

The UW clinical trial did not include children, but researchers say other studies are looking at whether antibiotics could work for pediatric patients.