According to a recent study, outpatient antibiotic management of selected appendicitis patients is safe, enabling many patients to avoid surgery and hospitalization, and should be explored as part of the doctor-patient shared decision-making process.
This research is a continuation of the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial, which showed that antibiotic treatment was not inferior to urgent appendectomy. Following the experiment, the American College of Surgeons declared that high-quality evidence suggested that antibiotics may be used to treat the majority of patients.
The researchers looked at data from 726 people who had imaging-confirmed appendicitis and were given antibiotics at 25 different hospitals between May 1, 2016, and February 28, 2020.
Within 24 hours, 46% of the 726 participants who were randomly assigned to receive antibiotics were released from the emergency room. In the week after release, outpatient management was linked with less than one serious adverse effect per 100 patients.
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.
The researchers believe that outpatient management of appendicitis is safe for many people and could decrease healthcare use and costs.
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