This conclusion was reached by a group of pediatric surgeons from several university medical centers in the US Midwest, whose article was published in the journal JAMA.
With uncomplicated appendicitis, abdominal pain lasts no more than 48 hours before going to the doctor, the level of leukocytes in the blood does not exceed 18,000 per microliter, the results of ultrasound, magnetic resonance imaging or computed tomography show that the diameter of the appendix does not exceed 1.1 centimeters, in the abdominal there is no abscess or phlegmon (purulent inflammation) in the cavity, and there are no fecal stones (coprolites) in the intestines.
A pilot study conducted by the same team of pediatric surgeons, the results of which were published in 2015, showed that for uncomplicated inflammation of the appendix of the cecum in children, it is quite possible to do without surgery.
The children, who were prescribed a course of antibiotics instead of surgery, successfully recovered and were discharged home.
A new, larger study aimed to confirm the efficacy and safety of antibiotic treatment for uncomplicated appendicitis in children. The study involved over 1,000 children, ages seven to 17, who were treated for uncomplicated appendicitis at ten children’s hospitals in seven US states between May 2015 and October 2018. These patients were monitored until October 2019. In 370 cases, the child’s parents or guardians opted for antibiotic treatment, and 698 children underwent surgery to remove their appendix.
As a result, it was found that 67.1% of those children who were treated with antibiotics alone did not have any negative side effects, and they did not need surgery for a year after taking the drugs. At the same time, antibiotic therapy allowed children and their parents to spend less time on sick leave – an average of 6.6 days, while children who underwent surgery were forced to miss school on average for almost 11 days.
In addition, the drug treatment of appendicitis allows you to avoid possible complications both during the operation, which is performed under general anesthesia, and after it, surgeons say.
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