Antibiotics Preventing Surgery?

June 22, 2015

Surgery Door SignCut first and ask questions later is the standard of care at many hospitals, but reform is occurring, one health issue at a time.

The latest to get a fresh look is appendectomies. Not enough is known about what causes the appendix to become inflamed (risking rupture and serious infection), but the way we’ve been treating it may be too severe. And with 1 in 10 people eventually getting appendicitis, it’s one worth a close look!

In a Finnish study, they compared treating acute appendicitis with antibiotics instead of scheduling surgery. In 186 out of 257 cases, the appendicitis was resolved without surgery, and for those who did require surgery, there were no complications from the delay.

Surgery is incredibly expensive (at least in the US), add to that possible complications (just being a patient in a hospital carries a risk of serious infection and even death from an HAI like MRSA or Pneumonia), and a course of antibiotics seems like a much preferable ideal.

What about antibiotic resistance? Currently, there’s no single bacteria strain blamed for appendicitis—appendicitis starts with blockage (a calcified stone, gallstone, or inflammation from an infection), then bacteria grow.

And surgery requires lots of antibiotics, too. In fact, most hospital stays start with a round of general antibiotics to clear out minor infections.

The bigger problem will be getting hospitals to accept the change. Hospitals have a bigger financial incentive to push surgery—and it often takes less time (doctors cut rather than administer to patients and monitor).

Symptoms of appendicitis can vary greatly from person to person—pain is probably the most common, but vomiting/nausea, and lack of appetite can also occur. If the appendix burst, there’s serious risk of further infection (sepsis).

The first step will have to be an official recommendation. The second will have to be patients advocating for themselves!

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