Study finds antibiotics can treat appendicitis

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The study found that outpatients missed fewer days of work (2.6 versus 3.8) and had a comparable frequency of health care visits to inpatients.

Researchers have found that antibiotics are often effective in treating patients with appendicitis.

According to a recent study, outpatient antibiotic management of some patients with appendicitis is safe, allowing many patients to avoid surgery and hospitalization, and should be explored as part of the physician-to-physician shared decision-making process. patient.

This research is a continuation of the CODA (Comparison of Outcomes of Antibiotic Drugs and Appendectomy) trial, which showed that antibiotic treatment was not inferior to emergency appendectomy. Following the experiment, the American College of Surgeons said high-quality evidence suggested antibiotics could be used to treat the majority of patients.

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

Within 24 hours, 46% of the 726 participants who were randomly assigned to receive antibiotics were discharged from the emergency room. Within one week of discharge, outpatient management was associated with less than one serious adverse event per 100 patients.

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 with hospitalization, outpatient management was no longer associated with subsequent appendectomies, and patients missed fewer days of work.

Researchers believe that outpatient management of appendicitis is safe for many people and could reduce healthcare utilization and costs.

Reference: “Analysis of Outcomes Associated with Outpatient Management of Nonoperative Patients Treated with Appendicitis” by the Writing Group for the CODA Collaboration, July 1, 2022, Open JAMA Network.
DOI: 10.1001/jamanetworkopen.2022.20039

Dr. David Talan, professor of emergency medicine and infectious disease/medicine at UCLA’s David Geffen School of Medicine, is the co-principal investigator of the CODA trial. The trial included dozens of researchers across the United States, including UCLA investigators from the Departments of Surgery and Emergency Medicine at Olive View-UCLA Medical Center and Harbor-UCLA Medical Center: Dr. Dan DeUgarte, Dr. Gregory Moran and Dr. Amy Kaji. .

The study was funded by the Patient-Centered Outcomes Research Institute.

The authors disclosed financial ties to the pharmaceutical industry.

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