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Antibiotics alone for treatment of children with appendicitis is cost-effective and safe alternative to surgery
Medical Xpress / American College of Surgeons / Journal of the American College of Surgeons ^ | Nov. 26, 2024 | Lindsay A Gil et al

Posted on 12/10/2024 8:32:37 PM PST by ConservativeMind

Using antibiotics alone to treat children with uncomplicated appendicitis is a cost-saving alternative to surgery, according to a study.

The analysis was based on a review of data from more than 1,000 patients, aged 7 to 17, who were treated for uncomplicated acute appendicitis at several hospitals throughout the Midwest region between 2015 and 2018. Parents were given the choice of two treatment strategies—antibiotics alone or urgent laparoscopic appendectomy. Nonoperative management consisted of at least 24 hours of intravenous antibiotics. Patients whose symptoms did not resolve underwent laparoscopic appendectomy during the same hospital admission.

Ratio of costs-to-charges-based data (cost divided by the charges) for the initial hospitalization, readmissions, and unplanned emergency department visits were extracted from the Pediatric Health Information System, which captures data from approximately 50 children's hospitals.

A quality-adjusted life year score indicating normal health without issues would be about .95. Quality-adjusted life year scores were evaluated for each patient and compared. Patients were followed for one year, and total average costs for each strategy were calculated in 2023 dollars.

Of 1,068 patients, 370 chose antibiotics alone and 698 opted for urgent laparoscopic appendectomy.

The results show an average cost of $9,791 and 0.884 quality-adjusted life years per patient for laparoscopic appendectomy and $8,044 and 0.895 quality-adjusted life years per patient for nonoperative management.

Nonoperative management was both less costly and more effective in three analyses, including an analysis using disability days and alternative methods of calculating quality of life and cost over one year.

"Our study findings add an additional benefit to the antibiotics-only approach being safe and effective for children in that this strategy is shown to be cost effective," Dr. Minneci said. "In short, nonoperative management is a safe and cost-effective initial therapy and a reasonable alternative to surgery."

(Excerpt) Read more at medicalxpress.com ...


TOPICS: Health/Medicine
KEYWORDS: antibiotics; appendicitis; appendix
Antibiotics were a great way to eliminate surgery, although if they did not address the issue within a short period of time, they performed the surgery.

Personally, I would not have expected antibiotics to work so well.

I would always want a non-invasive approach, when possible.

1 posted on 12/10/2024 8:32:37 PM PST by ConservativeMind
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2 posted on 12/10/2024 8:33:16 PM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: ConservativeMind

As long s the appendix is not packed full of *stuff* I can see it working.

I think in other cases, where the appendix is blocked up, the surgery is the better option, unless they can figure out some way of removing the blockage and cleaning out the infected material.

I wonder how much of that is triggered by our poor diets and if a diet with enough roughage and fiber to keep someone regular would actually help prevent appendicitis.


3 posted on 12/10/2024 9:34:27 PM PST by metmom
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To: ConservativeMind

Its because bad bacteria start to overwhelm the resevoir of good bacteria in the appendix. Its not surprising they can deal with it if caught early. Hopefully though they do also give proper probiotics so that they can add more good bacteria into recolonize the gut (and thus, the appendix).


4 posted on 12/10/2024 9:37:37 PM PST by Secret Agent Man (Gone Galt; not averse to Going Bronson.)
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To: ConservativeMind

Inflammation of the appendix can cause a rupture at any time. This is not something to mess around with! It’s simple surgery for a non-ruptured appendix.
The surgery for a ruptured appendix is more extensive and it doesn’t take much time for peritonitis to occur. The whole area becomes full of puss and necrotic.
I for one would not take the risk if it was my child.
But then the hospital system can charge more for the surgery if the appendix ruptures, so go figure.


5 posted on 12/10/2024 9:46:09 PM PST by doc maverick
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To: ConservativeMind

Great, looking forward to another attack which you might not live through.


6 posted on 12/10/2024 10:08:26 PM PST by bgill
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To: ConservativeMind

Is this insinuating that gut biome is an underlying cause of appendicitis?


7 posted on 12/11/2024 1:06:08 AM PST by tired&retired (Blessings )
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To: ConservativeMind

I had mine removed. They took it out through my belly button. Soon as I woke up, I was able to walk. I went home.


8 posted on 12/11/2024 2:01:00 AM PST by roving (Deplorable MAGA Garbage )
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To: roving

I had appendicitis and they tried this antiobiotic treatment. Was fine for nearly a year and then appendicitis came back with a nasty vengeance. Had to have the surgery anyway.


9 posted on 12/11/2024 2:34:10 AM PST by freepertoo
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To: ConservativeMind

“...according to a study....”

Study funded by health insurance industry. Would be a lot more ruptured appendixes, expenses and deaths.


10 posted on 12/11/2024 3:32:37 AM PST by Bonemaker (invictus maneo)
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To: tired&retired

Yes.


11 posted on 12/11/2024 5:24:33 AM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: ConservativeMind

I subscribe to Retraction Watch, which catalogues bogus research studies that get published. I think they’re in the neighborhood of 45,000 retracted articles.

Which is to say I don’t believe any study until it’s independently verified. Including this one.


12 posted on 12/11/2024 5:50:47 AM PST by JusPasenThru (We are Free to be Americans Again.)
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To: ConservativeMind

When I was 65 I got appendicitis. I begged the docs to give me antibiotics instead of surgery but they wouldn’t listen. Said that I would have to be in the hospital with intervenous antibiotics for seven days and that will cost a lot more. I had read an article by Dr Mercola that said it was a better option to just take the antibiotic and never let them cut on you. Now I have a hernia from the surgery.
It’s been 10 Years.


13 posted on 12/11/2024 9:30:38 AM PST by tinamina (Remember when Biden said “we have developed the most sophisticated voting fraud system ever”?)
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To: ConservativeMind

Apparently, it’s all about the Benjamins. If I had a child with appendicitis, I would want Surgery for him. Peritonitus can still kill, and requires a lot more hospitalization than a simple appendectomy.


14 posted on 12/11/2024 10:49:52 AM PST by Flaming Conservative ((Pray with ceasing))
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To: metmom

They used to say it happened due to children swallowing bubble gum. I would think stomach acid would dissolve gum.


15 posted on 12/11/2024 10:51:54 AM PST by Flaming Conservative ((Pray with ceasing))
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To: ConservativeMind

On young folks. Age is a huge factor


16 posted on 12/11/2024 1:19:18 PM PST by Nifster ( I see puppy dogs in the clouds )
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