Saturday, September 13, 2014

Non-surgical management of appendicitis?

From a recent study:

During this 4-year study, we enrolled 26 elderly patients who initially received antibiotic therapy. Of these, 3 were suspected to have complicated appendicitis. Antibiotic therapy consisted of second-generation cephalosporin and metronidazole that was administered for 4 days with a 24 h fasting period. We evaluated the rates of treatment failure and recurrence.

Mean age was 83.5 years and 57.7% (15/26) of patients had comorbidities. One patient (4.8%) failed to respond to antibiotic therapy and underwent subsequent appendectomy. During the median follow-up period of 17 months, 5 patients (20%) experienced recurrence; 3 underwent appendectomy and two received a new course of antibiotics.

Antibiotic therapy without surgery may be a safe and an effective treatment for appendicitis in selective patients aged greater than or equal to 80 years. This is a good treatment option in patients with high operative risk.

Via Hospital Medicine Virtual Journal Club.

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