Most appendicitis patients can be treated with antibiotics: many can be treated on an outpatient basis, avoiding surgery and hospitalization


Outpatient antibiotic management of some patients with appendicitis is safe, allowing many patients to avoid surgery and hospitalization, and should be considered part of shared decision-making between physician and patient. Of 726 participants randomized to receive antibiotics, 46% were discharged from the emergency department within 24 hours. Outpatient management was associated with less than one serious adverse event per 100 patients within one week of discharge.

Outpatient management was shown to be safe for a wide range of patients and was performed in up to 90% of antibiotic-treated patients at all study sites. Compared to hospitalization, outpatient management was no longer associated with subsequent appendectomies, and patients missed fewer days of work.

This study is an ongoing analysis of the results of the CODA (Comparison of Outcomes of Antibiotic Drugs and Appendectomy) trial, which found that antibiotic treatment was not inferior to emergency appendectomy. Following the trial, the American College of Surgeons said high-quality evidence indicated that most patients could be treated with antibiotics.

The researchers looked at data from 726 people with imaging-confirmed appendicitis who were treated with antibiotics at 25 hospitals between May 1, 2016 and February 28, 2020.

Outpatient management of appendicitis is safe for many people and could reduce healthcare utilization and costs.

Source of the story:

Materials provided by University of California – Los Angeles Health Sciences. Note: Content may be edited for style and length.

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