In a U.S. pilot study, 13% of patients randomized to antibiotics-only developed appendicitis again during 1 year of follow-up.
European studies have suggested that antibiotics are a reasonable alternative to surgery for uncomplicated appendicitis, but in the largest of them, appendicitis recurred in 27% within 1 year (NEJM JW Emerg Med Jun 16 2015; [e-pub] and JAMA 2015 Jun 16; 313:2340). Now, in a multicenter U.S. pilot study, investigators examined outpatient antibiotics-only management of appendicitis.
Thirty patients with uncomplicated appendicitis were randomized to immediate appendectomy or antibiotics (intravenous ertapenem in the emergency department [ED] and on a return visit the next day, followed by cefdinir and metronidazole orally for 8 days). All were adults, except for one child (age 9 years) who was assigned to the antibiotics group and hospitalized …
Reviewing Author
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals