{"id":2943,"date":"2023-10-30T03:35:37","date_gmt":"2023-10-30T03:35:37","guid":{"rendered":"http:\/\/drhimanshuyadav.com\/most-patients-treated-with-antibiotics-for-acute-appendicitis-do-not-experience-recurrence\/"},"modified":"2023-10-30T03:35:37","modified_gmt":"2023-10-30T03:35:37","slug":"most-patients-treated-with-antibiotics-for-acute-appendicitis-do-not-experience-recurrence","status":"publish","type":"post","link":"https:\/\/drhimanshuyadav.com\/blog\/most-patients-treated-with-antibiotics-for-acute-appendicitis-do-not-experience-recurrence\/","title":{"rendered":"Most patients treated with antibiotics for acute appendicitis do not experience recurrence"},"content":{"rendered":"<div data-component=\"ArticleContent\">\n<div class=\"article__content--header\">\n<div class=\"article__posted-date\">\n<p>    August 23, 2023 <\/p>\n<p>    2 minute read <\/p>\n<\/p><\/div>\n<\/div>\n<div class=\"mobile-trust-box\">\n<div class=\"row\">\n<div class=\"col-12 col-md-5 d-xl-none\">\n<div class=\"trust-box\">\n<div class=\"trust-box-logo d-none d-md-block\">\n          <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.healio.com\/~\/media\/h5\/feature\/news\/publogos\/hgld\/healio_gastro.svg?h=40&amp;w=152&amp;la=en&amp;hash=2C654A538F2E250F5183D42A89FE0EC0\" height=\"40\" width=\"152\" class=\"logo-img\" alt=\"Helio Logo - Gastroenterology\"\/>\n        <\/div>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"col-12 col-md-6 offset-md-1 offset-xl-0 col-xl-12\">\n<div class=\"d-none\" data-component=\"EmailTopicAlert\" data-module=\"Subspecialty Email Topic Alerts Top\" data-manage-email-link=\"\/footer\/account-information\/my-account\/email-subscriptions-and-alerts#emailAlerts\">\n  <hidden data-setting-item=\"d265901d-6d37-49c7-a8f6-c7bf19a02509\"\/><br \/>\n  <hidden data-crm-source=\"Subspecialty Topic Alert\"\/><\/p>\n<div class=\"email-alert-button d-none\" data-topic-button=\"not-subscribed\">\n<p>&#13;<br \/>\n      <span data-module-track-action=\"Email Alerts TOP_Click_Healio News Article\" data-module-track-label=\"Email Alerts TOP_Healio News Article\">&#13;<br \/>\n        <i class=\"fas fa-plus-circle\"\/>Add topics to email alerts<br \/>\n      <\/span>&#13;\n    <\/p>\n<div class=\"email-alert-inner collapse u1159b7ab33ca4c7dbcf815fc77ef6df5\">\n<div class=\"email-alert-dialogue\">\n<p>Receive an email when a new article is posted <span data-content=\"topic-title\"\/>&#13;\n        <\/p>\n<div class=\"d-none\" data-sign-up-type=\"unknown\">\n<p>          Enter your email address to receive emails when new articles are posted. <span data-content=\"topic-title\"\/>.<\/p><\/div>\n<\/p><\/div>\n<p>      <button type=\"button\" class=\"btn btn-primary\" data-loading-text=\"Loading &lt;i class=\" fa=\"\" fa-spinner=\"\" fa-spin=\"\">&#8221; data-action=&#8221;subscribe&#8221;> Subscribe<br \/>\n      <\/button>\n    <\/div>\n<\/p><\/div>\n<div class=\"d-none\" data-topic-modal=\"failed\">    <strong>Your request could not be processed. Please try again later. If you continue to experience this issue, please contact us at customerservice@slackinc.com.<\/strong>  <\/p>\n<p><button data-dismiss=\"modal\" class=\"btn btn-primary btn-lg btn-block\">Return to Helio<\/button><\/p>\n<\/div>\n<\/div><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<h4>Important points:<\/h4>\n<ul>\n<li>Initial antibiotic treatment was successful in 88% to 95% of patients.<\/li>\n<li>At age 25, 60% of those treated with antibiotics had not undergone appendectomy, and 71% were discharged without appendectomy and remained without surgery.<\/li>\n<\/ul>\n<p>More than half of patients treated with antibiotics for acute appendicitis avoid surgery for up to 25 years, and researchers report that there is no evidence of long-term risks from nonoperative management other than recurrence.<\/p>\n<p>&#8220;The longest reported outcome for patients treated nonsurgically for acute appendicitis was 5 years.&#8221; <strong>Dr. Barbora Patcova,<\/strong> Researchers from Sweden&#8217;s Karolinska Institute and Uppsala University Hospital wrote: <em>JAMA surgery<\/em>.<\/p>\n<figure class=\"figure article__og-image\">&#13;\n    <picture>&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/gastroenterology\/misc\/infographics\/2023\/0823\/hgi0823patkova_graphic_01.webp?w=476\" media=\"(max-width: 768px)\">&#13;<source srcset=\"https:\/\/www.healio.com\/~\/media\/slack-news\/gastroenterology\/misc\/infographics\/2023\/0823\/hgi0823patkova_graphic_01.webp?w=800\" media=\"(max-width: 992px)\">&#13;<source srcset=\"https:\/\/www.healio.com\/~\/media\/slack-news\/gastroenterology\/misc\/infographics\/2023\/0823\/hgi0823patkova_graphic_01.webp?w=595\" media=\"(max-width: 1200px)\">&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/gastroenterology\/misc\/infographics\/2023\/0823\/hgi0823patkova_graphic_01.webp?w=476\" media=\"(min-width: 1200px)\">&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/gastroenterology\/misc\/infographics\/2023\/0823\/hgi0823patkova_graphic_01.webp?w=476\">&#13;<br \/>\n&#13;<br \/>\n      <img decoding=\"async\" src=\"https:\/\/www.healio.com\/~\/media\/slack-news\/gastroenterology\/misc\/infographics\/2023\/0823\/hgi0823patkova_graphic_01.jpg?w=800\" alt=\"At the end of long-term follow-up, 60% of patients had not undergone appendectomy, and 71% of patients who were successfully discharged without appendectomy did not return for surgery.\" class=\"figure-img img-fluid\" width=\"800\"\/>&#13;<br \/>\n    <\/source><\/source><\/source><\/source><\/source><\/picture>&#13;<figcaption class=\"figure-caption\">Data origin: P\u00e1tkov\u00e1 B, et al. <i>JAMA Surg.<\/i> 2023;doi:10.1001\/jamasurg.2023.2756.<br \/>\n    <\/figcaption>&#13;<br \/>\n  <\/figure>\n<p>To determine long-term outcomes for 19- to 26-year-olds, researchers analyzed data from the Swedish National Registry of participants in two randomized clinical trials comparing appendectomy with nonsurgical treatment for acute appendicitis. . The first study included 40 patients (33% women) assigned to either appendectomy or antibiotics from May 1992 to March 1994, and the second study included 40 patients (33% women) from May 1992 to March 1994. 252 male patients randomly assigned to either treatment between March 2006 and June 1999 were included.<\/p>\n<p>Success of initial non-surgical treatment was reported in 95% (19 of 20) of patients in the first trial and 88% (113 of 128) in the second trial, with a 1-year recurrence rate of 36.8, respectively. % and 14.4%.<\/p>\n<p>Of the initial 292 participants, researchers were able to follow up 259 in the registry, of whom 92.6% were in the non-surgery group and 84.7% had appendectomy.  Twenty-one participants underwent appendectomy as a result of failure of initial nonoperative treatment, and 34 subsequently underwent appendectomy for acute appendicitis.<\/p>\n<p>At the end of follow-up, 60% of patients had not undergone appendectomy, and 71% of patients who were successfully discharged without appendectomy did not return for surgery.<\/p>\n<p>&#8220;While the incidence of appendectomy was low after the first year, appendectomies continued to occur up to 20 years later,&#8221; the researchers wrote.<\/p>\n<p>In addition to patients undergoing surgery after initial nonsurgical treatment failed, 9.5% of patients in the antibiotic group visited the outpatient clinic for abdominal pain, compared with 0.01% in the surgical group.<\/p>\n<p>&#8220;More than half of patients treated nonsurgically did not experience recurrence and avoided surgery for approximately 20 years,&#8221; the researchers wrote.  &#8220;Other than recurrence of appendicitis, there is no evidence of long-term risks from non-surgical management. These data will further inform treatment decisions, not only for patients with acute appendicitis, but also for clinicians. Sho.&#8221;<\/p>\n<div class=\"publisher-logo\">\n    <span>Issuer:<\/span><br \/>\n    <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.healio.com\/~\/media\/h5\/feature\/news\/publogos\/hgld\/healio_gastro.svg?h=40&amp;w=152&amp;la=en&amp;hash=2C654A538F2E250F5183D42A89FE0EC0\" class=\"logo-img\" width=\"152\" height=\"40\" alt=\"Helio Logo - Gastroenterology\"\/>\n  <\/div>\n<div class=\"sources-disclosures\">\n  <a class=\"title\" data-toggle=\"collapse\" data-target=\".sources-disclosures-toggle\" aria-controls=\"sources-disclosures-content\">Information source\/disclosure information<i class=\"fas\"\/><\/p>\n<p class=\"collapse-label show\">collapse<\/p>\n<p>&#13;<br \/>\n  <\/a><\/p>\n<div id=\"sources-disclosures-content\" class=\"sources-disclosures-toggle collapse show\">\n<p>&#13;<br \/>\n        <strong> Disclosure: <\/strong>Ms. Patkova has not reported any relevant financial disclosures. Please refer to this study for relevant financial disclosures of all other authors.\n      <\/p>\n<\/p><\/div>\n<\/div>\n<div class=\"article__content--footer\">\n<div class=\"perspective\">\n<p>  <a id=\"537ABA60253D47238057D17ED9BB59B2\"\/><\/p>\n<p>  <a id=\"perspective\" name=\"perspective\"\/><\/p>\n<h2 class=\"title\">perspective<\/h2>\n<p>  <a class=\"back-to-top\" href=\"\/blog\/#top\">    Return to top <i class=\"far fa-arrow-up\"\/> <\/a><br \/>\n  <img decoding=\"async\" src=\"https:\/\/www.healio.com\/~\/media\/slack-news\/gastroenterology\/mugs\/a\/alaedeen_diya_2023.jpg?h=105&amp;w=79&amp;la=en&amp;hash=F1FB1E706A002CCC076148EFC9185EEA\" class=\"perspective-img\" alt=\"Dr. Diya Aladeen, FACS)\"\/><\/p>\n<div class=\"perspective-body\">\n<p class=\"name\">Dr. Diya Aladeen, FACS<\/p>\n<p class=\"Perspective\">Although this is interesting data regarding the long-term outcomes of nonoperative treatment of appendicitis, the results require more scrutiny and interpretation. We need to continue to look for predictors of non-surgical failure (patients returning to surgery after antibiotic treatment). <\/p>\n<p class=\"Perspective\">The more data we can collect on this topic through high-fidelity research protocols, the better we can consult with patients about treatments that will ensure the best long-term outcomes and reduce the likelihood of disease recurrence and complications. It will be like this.<\/p>\n<div class=\"position\">\n<p>Dr. Diya Aladeen, FACS<\/p>\n<p>Chief of Surgery, Cleveland Clinic Fairview Hospital<\/p>\n<p>Medical Director, Cleveland Clinic Fairview Ambulatory Surgery Center<\/p>\n<p>Cleveland Clinic Digestive Disease Institute General Surgeon<\/p>\n<\/p><\/div>\n<p>&#13;<br \/>\n      <strong> Disclosure: <\/strong> Alaedeen does not report any relevant financial disclosures.\n    <\/p>\n<\/p><\/div>\n<\/div>\n<div class=\"d-none\" data-component=\"EmailTopicAlert\" data-module=\"Subspecialty Email Topic Alerts Top\" data-manage-email-link=\"\/footer\/account-information\/my-account\/email-subscriptions-and-alerts#emailAlerts\">\n  <hidden data-setting-item=\"d265901d-6d37-49c7-a8f6-c7bf19a02509\"\/><br \/>\n  <hidden data-crm-source=\"Subspecialty Topic Alert\"\/><\/p>\n<div class=\"email-alert-button d-none\" data-topic-button=\"not-subscribed\">\n<p>&#13;<br \/>\n      <span data-module-track-action=\"Email Alerts TOP_Click_Healio News Article\" data-module-track-label=\"Email Alerts TOP_Healio News Article\">&#13;<br \/>\n        <i class=\"fas fa-plus-circle\"\/>Add topics to email alerts<br \/>\n      <\/span>&#13;\n    <\/p>\n<div class=\"email-alert-inner collapse u1159b7ab33ca4c7dbcf815fc77ef6df5\">\n<div class=\"email-alert-dialogue\">\n<p>Receive an email when a new article is posted <span data-content=\"topic-title\"\/>&#13;\n        <\/p>\n<div class=\"d-none\" data-sign-up-type=\"unknown\">\n<p>          Enter your email address to receive emails when new articles are posted. <span data-content=\"topic-title\"\/>.<\/p><\/div>\n<\/p><\/div>\n<p>      <button type=\"button\" class=\"btn btn-primary\" data-loading-text=\"Loading &lt;i class=\" fa=\"\" fa-spinner=\"\" fa-spin=\"\">&#8221; data-action=&#8221;subscribe&#8221;> Subscribe<br \/>\n      <\/button>\n    <\/div>\n<\/p><\/div>\n<div class=\"d-none\" data-topic-modal=\"failed\">    <strong>Your request could not be processed. Please try again later. If you continue to experience this issue, please contact us at customerservice@slackinc.com.<\/strong>  <\/p>\n<p><button data-dismiss=\"modal\" class=\"btn btn-primary btn-lg btn-block\">Return to Helio<\/button><\/p>\n<\/div>\n<\/div>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>August 23, 2023 2 minute read &#13; &#13; Add topics to email alerts &#13; Receive an email when a new article is posted &#13; Enter your email address to receive emails when new articles are posted. . &#8221; data-action=&#8221;subscribe&#8221;> Subscribe Your request could not be processed. Please try again later. 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