Posted on 07/07/2022 8:37:10 AM PDT by ConservativeMind
Outpatient antibiotic management of selected patients with appendicitis is safe, allowing many patients to avoid surgery and hospitalization, and should be considered as part of shared decision-making between doctor and patient. Of 726 participants who were randomized to receive antibiotics, 46% were discharged from the emergency department within 24 hours.
Outpatient management was associated with fewer than 1 serious adverse effect per 100 patients in the week after their discharge. Outpatient management was shown to be safe across a wide range of patients and was done in up to 90% of antibiotic-treated patients across all study sites. Compared to hospitalization, outpatient management was not associated with any more subsequent appendectomies and patients missed fewer workdays.
This study is a continuing analysis of findings from the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial, which found that antibiotic treatment was non-inferior to urgent appendectomy. Following the trial, the American College of Surgeons stated that high-quality evidence indicated that most patients can be treated with antibiotics.
The researchers examined 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 decrease healthcare use and costs.
(Excerpt) Read more at medicalxpress.com ...
This does work.
And, from a neutral point of view, if 90% of young healthy people with appendicitis can be managed medically, that’s great.
But trial lawyers do not have a neutral point of view.
When noninvasive treatment fails (which does happen), the cleanup can be worse than the appendectomy which didn’t happen originally.
Had my appendix removed in May. Arrived at hospital ER on Friday night, had it removed Saturday morning, went home Sunday afternoon.
Interesting...my nephew’s wife just had surgery for appendicitis two weeks ago!
I wonder how much of this is about the risk of nosocomial infection while in the hospital.
Folks better start asking...
I do some hiking and canoeing in quite remote areas... gone for weeks at a time. In immediate family, several older siblings have had their appendectomy and it always gives me pause for thought as I get deeper from civilization....I wonder if I could talk my doctor into giving me a prescription to use in the event of an emergency.....
I worked at a hospital where they removed the appendix of virtually everyone who was hospitalized. It was a running joke...we’d ask everyone walking in or being wheeled in if they were there for an appendectomy...if not, we would tell them we had a special running “today only” if they wanted it removed.
It’s not entirely an either/or thing. Do I have it removed or do I treat it with medications?
You could keep some antibiotics handy, just in case, and if your appendix flared up you could immediately begin taking them in an attempt to forestall a rupture while making all haste to obtain surgical treatment. If I was far away from help I would start taking them at the slightest hint of a problem... If I was going to be far from help in the wilderness I’d also want one of those tiny satellite enabled devices that let you sent text messages.
Amoxicillin is a good antibiotic to keep a supply of, it’s usually combined with other antibiotics to treat a cranky appendix though. If I was in the wilderness and started having symptoms I’d take an initial loading dose of a gram and then 500mg every 8 hours... in a hospital setting they would start with intravenous administration and them perhaps go to oral.
A troublesome appendix is a bit like having the sword of Damocles hanging over you all the time, not a pleasant thing. Personally, I’d want the appendix removed to be done with the hassle once and for all... I’d feel similarly with something like a bad case of hemorrhoids, just get the problem fixed and move on.
https://pubmed.ncbi.nlm.nih.gov/25121154/
Had it removed with a one day stay, arrived in the morning, out that evening, the following year, three small holes. It only took that long because of Covid, and the VA wasn't accepting "elective" procedures.
Thanks for your comments and advice... much appreciated.
I’ll have mine removed before that beauty decides to rupture!
Well if it works, great. I had mine out, and there was absolutely no mystery that something was seriously wrong as I couldn’t even hold down water. If the antibiotics aren’t working, hopefully the symptoms will alert the patient that something badly needs to be done. My biggest problem was that I got bounced from doctor to doctor because they all thought I was pregnant. I nearly died as a result of the delay because of that.
I had appendicitis treated with antibiotics rather than surgery 3 years ago. No problems since then
My understanding is that Traditional Chinese Medicine (TCM) can easily treat appendicitis with a short-term herbal treatment.
If you have a good TCM practitioner near you, it is worth checking out for this condition or any other condition where the standard of care for Western Medicine includes surgery.
“A troublesome appendix is a bit like having the sword of Damocles hanging over you all the time, not a pleasant thing.”
Came here to say exactly that. Wouldn’t want an attack or rupture to happen at an inopportune time in an inopportune place!
Laproscopic?
In my lifetime I have seen on two different occasions, a person literally rolling on the ground howling in pain due to their appendix having gone bad.
Yes, but they warned me that in some cases they may need to do it the old incision style. Fortunately they were able to do it laporoscopically. I had 3 small holes on the left side.
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