Most patients with appendicitis can be treated with antibiotics
Many can be treated as outpatients, avoiding surgery and hospitalization
- Date:
- July 6, 2022
- Source:
- University of California - Los Angeles Health Sciences
- Summary:
- Outpatient antibiotic management of selected patients with appendicitis is safe, allowing many patients to avoid surgery and hospitalization, and should be considered as part of shared decision-making between doctor and patient.
- Share:
Outpatient antibiotic management of selected patients with appendicitis is safe, allowing many patients to avoid surgery and hospitalization, and should be considered as part of shared decision-making between doctor and patient. Of 726 participants who were randomized to receive antibiotics, 46% were discharged from the emergency department within 24 hours. Outpatient management was associated with fewer than 1 serious adverse effect per 100 patients in the week after their discharge.
Outpatient management was shown to be safe across a wide range of patients and was done in up to 90% of antibiotic-treated patients across all study sites. Compared to hospitalization, outpatient management was not associated with any more subsequent appendectomies and patients missed fewer workdays.
This study is a continuing analysis of findings from the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial, which found that antibiotic treatment was non-inferior to urgent appendectomy. Following the trial, the American College of Surgeons stated that high-quality evidence indicated that most patients can be treated with antibiotics.
The researchers examined data from 726 people with imaging-confirmed appendicitis who were treated with antibiotics at 25 hospitals between May 1, 2016 and February 28, 2020
Outpatient management of appendicitis is safe for many people and could decrease healthcare use and costs.
Story Source:
Materials provided by University of California - Los Angeles Health Sciences. Note: Content may be edited for style and length.
Journal Reference:
- Charles Parsons, Stephen Odom, Randall Cooper, Katherine Fischkoff, Brant Putnam, Dennis Kim, Erin C. Howell, Lara H. Spence, Ross Fleischman, Erika Wolff, Farhood Farjah, Hikmatullah Arif, Kelsey Pullar, Laura Hennessey, Alyssa Hayward, Lillian Adrianna Hayes, Vance Sohn, Bruce Chung, Damien Carter, David MacKenzie, Debra Burris, Joseph Mack, Terilee Gerry, Darin Saltzman, Debbie Mireles, Formosa Chen, Kavitha Pathmarajah, Paul J Schmit, Robert Bennion, Melinda Gibbons, Bruce Wolfe, Elliott Skopin, Heather VanDusen, Kimberly Deeney, Mary Guiden, Meridith Weiss, Miriam Hernandez, Brandon Tudor, Careen Foster, Shaina Schaetzel, Arden Morris, Dayna Morgan, John Tschirhart, Julie Wallick, Katherine Mandell, Ryan Martinez, Sean Wells, Steven Steinberg, Jason Maggi, Kristyn Pierce, Marcovalerio Melis, Mohamad Abouzeid, Paresh Shah, Prashant Sinha, Cathy Fairfield, Dionne Skeete, Cindy Hsu, Krishnan Raghavendran, Nathan Haas, Norman Olbrich, Pauline Park, Hasan Alam, Deepti Patki, Rebekah K. Peacock, Donald M. Yealy, Debbie Lew, Karla Bernardi, Naila Dhanani, Oscar Olavarria, Stephanie Marquez, Tien C. Ko, Amber Sabbatini, Estell Williams, Karen Horvath, Zoe Parr, Karen F. Miller, Kelly M. Moser, Abigail Wiebusch, Julianna Yu, Scott Osborn, Billie Johnsson, Karla Ballman, Lauren Mount, Robert J. Winchell, Sunday Clark, Thomas Diflo, Kathleen O’Connor, Olga Owens, David A. Talan, Gregory J. Moran, Anusha Krishnadasan, Sarah E. Monsell, Brett A. Faine, Lisandra Uribe, Amy H. Kaji, Daniel A. DeUgarte, Wesley H. Self, Nathan I. Shapiro, Joseph Cuschieri, Jacob Glaser, Pauline K. Park, Thea P. Price, Nicole Siparsky, Sabrina E. Sanchez, David A. Machado-Aranda, Jesse Victory, Patricia Ayoung-Chee, William Chiang, Joshua Corsa, Heather L. Evans, Lisa Ferrigno, Luis Garcia, Quinton Hatch, Marc D. Horton, Jeffrey Johnson, Alan Jones, Lillian S. Kao, Anton Kelly, Daniel Kim, Matthew E. Kutcher, Mike K. Liang, Nima Maghami, Karen McGrane, Elizaveta Minko, Cassandra Mohr, Miriam Neufeld, Joe H. Patton, Colin Rog, Amy Rushing, Amber K. Sabbatini, Matthew Salzberg, Callie M. Thompson, Aleksandr Tichter, Jon Wisler, Bonnie Bizzell, Erin Fannon, Sarah O. Lawrence, Emily C. Voldal, Danielle C. Lavallee, Bryan A. Comstock, Patrick J. Heagerty, Giana H. Davidson, David R. Flum, Larry G. Kessler. Analysis of Outcomes Associated With Outpatient Management of Nonoperatively Treated Patients With Appendicitis. JAMA Network Open, 2022; 5 (7): e2220039 DOI: 10.1001/jamanetworkopen.2022.20039
Cite This Page: