Antibiotics kept 7 in 10 appendicitis patients out of surgery for 90 days

A nationwide trial in the United States tested whether antibiotics could replace the operation for most patients. More than fifteen hundred adults with appendicitis were randomly assigned to receive antibiotics first or to go straight to appendectomy.

Among those given antibiotics first, about seven in ten never needed surgery within ninety days, and scores on a general health measure at thirty days were no worse than with surgery. Patients with a hardened mass called an appendicolith were more likely to still need an operation.

The antibiotics group did have a higher rate of complications overall, and about three in ten eventually had their appendix removed anyway, often because symptoms returned. The trial did not end surgery as the default treatment, but it gave patients and doctors a real choice, with longer follow-up later confirming that most who avoided the first operation stayed appendix-free for years.

An emergency operation became a choice.