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from the now...on-to-the-tables-of-content dept.
After century of removing appendixes, docs find antibiotics can be enough:
After more than a century of slicing tiny, inflamed organs from people's guts, doctors have found that surgery may not be necessary after all—a simple course of antibiotics can be just as effective at treating appendicitis as going under the knife.
The revelation comes from a large, randomized trial out of Finland, published Tuesday, September 25, in JAMA.
Despite upending a long-held standard of care, the study's finding is not entirely surprising; it follows several other randomized trials over the years that had carved out evidence that antibiotics alone can treat an acute appendicitis. Those studies, however, left some dangling questions, including if the antibiotics just improved the situation temporarily and if initial drug treatments left patients worse off later if they did need surgery.
The new JAMA study, with its full, five-year follow-up, effectively cauterised those remaining issues. Nearly two-thirds of the patients randomly assigned in the study to get antibiotics for an uncomplicated appendicitis didn't end up needing surgery in the follow-up time, the Finnish authors, based at the University of Turku, report. And those drug-treated patients that did end up getting an appendectomy later were not worse off for the delay in surgery.
"This long-term follow-up supports the feasibility of antibiotic treatment alone as an alternative to surgery for uncomplicated acute appendicitis," the authors conclude.
The finding suggests that many appendicitis patients could be spared the risks of surgical procedures, such as infections. They may also be able to save money by not needing such an invasive procedure (although the study didn't compare costs), and they could reap the benefits of shorter treatment and recovery times. Researchers will have to collect more data to back up those benefits, though.
JAMA, 2018. DOI: 10.1001/jama.2018.13201
(Score: 2) by All Your Lawn Are Belong To Us on Saturday September 29 2018, @01:42AM
Even thirty years ago one might not have had the ability to get to a Doctor's Office or Emergency Room if one's condition worsened, let alone a century ago. One might just write off that tummy pain to bad indigestion and wait until one actually had an emergency on one's hands to seek care. (Still happens). The capability of both monitoring an infection's progress and also to make the call when an inflamed appendix needs to be removed pre-burst (and not) has likely improved as well. Not to mention we now believe that the appendix actually has beneficial function (where before it was removing something that was thought to have no function at all but just an evolutionary dead-end).
What you *don't* want is sepsis from a burst appendix. If it can be cured without surgery, great, and that's why progress in medicine is so cool when it comes to relieving pain and suffering better than we did yesterday. But better to take it than let a patient die of septic shock.
This sig for rent.