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After Century of Removing Appendices, Docs Find Antibiotics Can Be Enough Two-Thirds of the Time



After a few weeks of inflamed organs, the doctors have found it difficult to treat themselves as a result of the disease.

JAMA last week.

The upbringing of a long-held standard of care, the study's finding is not entirely surprising; antibiotics alone can treat acute appendicitis.

The new JAMA study, with its full, five-year follow-up, effectively cauterized those remaining issues. Nearly two-thirds of the patients randomly assigned in the study to get antibiotics for an uncomplicated appendicitis did not end up needing surgery in the follow-up time, says the Finnish researchers from the University of Turku authors.

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"The long-term follow-up supports the feasibility of antibiotic treatment alone as an alternative to surgery for uncomplicated acute appendicitis," the authors conclude.

Surgical procedures, such as infections. They may also be looking for an invasive procedure (although they did not compare costs), and they may reap the benefits of shorter treatment and recovery times.

For their initial look at the simpler appendicitis treatment, researchers led by Paulina Salminen randomly assigned to an acute, uncomplicated appendicitis to either a standard, open surgery to remove their inflamed organ or a course of antibiotics.

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The patients ranged from 1

8 to 60 and enrolled in the trial between November 2009 and June 2012. Those who stayed under the knife stayed in the hospital for a median of three days, while the

A couple of patients were lost in follow-up, including one from an unrelated death, leaving 272 patients in the surgery group and 256 in the antibiotic group.

In the antibiotic group, the first year of treatment. Within the following five years, 30 others therefore underwent surgery. That left 156 antibiotic-treated patients, or about 61 percent, who were able to escape the scalpel. [194559002] CHECK OUT : New Study Shows That Weight Loss Can Be Boosted Fivefold Thanks to Novel Mental Imagery Technique 19659002] The authors think that could even be higher in follow-up studies. They could not be treated as they were. The antibiotics alone could treat appendicitis. This fact, the authors note, could have artificially inflated the number of people who ended up getting an appendectomy. They point out that seven of the 100 antibiotic-resistant patients who underwent surgery did not actually have evidence of appendicitis at the time of their surgery, based on their medical records.

recoveries overall. The antibiotic group has a complication rate of 6.5 percent, which has been assigned to surgery had a rate of 24 percent, mostly due to infections. Of the 100 antibiotic-treated patients who had later surgery, they had typical complication rates for the procedure.

Complications or not, the antibiotic group took a median of 11 days of sick leave to recover, while the surgery group took 22 days. [19659002] LOOK : Got Kidney Stones? Ride a Roller Coaster, Says Study

There were a couple of catches to the study that warrant follow-up. One big issue is antibiotic treatment to standard, open surgery-not a modern, minimally invasive laparoscopic surgery, which is now common in the US.

That said, the authors note that the antibiotic treatment was so heavy -handed in the study. The researchers proceeded with a "conservative" three-day IV treatment followed by more oral antibiotics, which may have been overkill. They did this because "[w] this protocol was designed, there is little information available on the application of antibiotic treatment for appendicitis," they note. Future studies could find that shorter, less intense courses of antibiotics could also do the trick, further reducing complication rates and treatment time.

Last, the study did not compare the costs of the interventions those in the two treatment groups.

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