Some cases of pediatric appendicitis can be resolved with antibiotics, Hasbro Children’s Hospital reports

PROVIDENCE – Acute appendicitis is the most common surgical emergency in children, with more than 70,000 patients younger than 18 undergoing the procedure each year in the U.S. But, with a recent change in treatment protocols, some children with appendicitis may be treated successfully with intravenous antibiotics – far less invasive than surgery – according to a statement from Hasbro Children’s Hospital, a Lifespan facility.

“Operative appendectomy has been the gold standard treatment for acute appendicitis for more than 100 years. At present, the procedure is performed with very low risk and few negative outcomes,” Dr. Francois Luks, interim pediatric-surgeon-in-chief of Hasbro, said in a statement. “However, non-operative treatment of early uncomplicated appendicitis could, if successful, help avoid surgery altogether.”

“If you asked most parents what happens if their child gets appendicitis, the usual response would be, ‘They would need surgery to remove the appendix.’ For a long time that was true,” Dr. Christopher Muratore, a pediatric surgeon at Hasbro, said in the statement. “We want parents to know now that, if your child comes to the hospital with an early case of appendicitis, it may not automatically result in surgery anymore. In select cases, we may actually be able to fully resolve the appendicitis with antibiotics alone.”

A study in children at Hasbro Children’s Hospital, published earlier this year, demonstrated that non-operative treatment is 90 percent successful in eliminating the signs and symptoms of early appendicitis. As not all cases of appendicitis are considered early, the antibiotic, non-operative approach may only be used with some 20 percent of patients with confirmed acute appendicitis. Patients were hospitalized for less than a day and could return to their regular routine within a few days. Perhaps not surprisingly, the non-surgical intervention was ranked more favorably by patients and their parents than the rankings for either laparoscopic or open appendectomy, Hasbro reported.

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“Any surgical intervention is associated with pain, discomfort and the risk of complications – it affects the overall quality of life for children,” Luks said. “But also, because of the high prevalence of appendicitis in children, this represents a significant health care burden. These new non-surgical measures have the potential to radically reduce the burden of appendicitis, not only on patients and their families, but on society and health care systems, as well.”

If ignored or treated improperly, appendicitis can still be a dangerous disease, Luks emphasized; as such, any treatment, whether with surgery or antibiotics alone, must be performed in a hospital setting. Antibiotic treatment must be administered intravenously in a hospital; only if a patient shows clear signs of improvement can he or she be discharged to go home and take oral antibiotics, he added.

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