Most patients with uncomplicated appendicitis who were placed on antibiotic therapy avoided an appendectomy or significant complications after a delayed appendectomy within one year, according to a study published online ahead of print June 16 in JAMA. 

Lead author Paulina Salminen, MD, PhD, and colleagues randomly assigned 530 patients with uncomplicated acute appendicitis that was confirmed by CT to receive antibiotic therapy for 10 days or a standard appendectomy. Appendectomy was successful at a rate of 99.6% for the 273 patients in that treatment group.

Of the 256 patients in the antibiotic group who were available for one-year follow-up, 186 (72.7%) did not require an appendectomy, and 70 (27.3%) did. No intra-abdominal abscesses or other major complications were associated with delayed appendectomy in the patients assigned to antibiotic treatment. 

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Based on their analysis, however, the authors said they could not conclude that antibiotic therapy was just as effective as appendectomy for uncomplicated acute appendicitis. 

“Nevertheless, the majority (73%) of patients with uncomplicated acute appendicitis were successfully treated with antibiotics,” they wrote. “These results suggest that patients with CT-proven uncomplicated acute appendicitis should be able to make an informed decision between antibiotic treatment and appendectomy.”