“Appendicitis is an obstructed, ischemic ticking time bomb of a finger-like extension of the bowel, which if not urgently removed will burst and lead to death.”
For more than 100 years, this understanding guided practice and patient expectations, with appendectomy becoming the most common emergency surgery.
We are now learning this was wrong.
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2 Responses to “Antibiotics May Be Effective for Managing Appendicitis”
April 30, 2017
Robert Bostic, PA-C, HMC(SS) USN RETGreat article.
The use of iv abx in the treatment of appendicitis, is the mainstay of treatment used by Independent Hospital Corpsmen in Submarine Service since the early 1980’s. Diagnosis was done by physical exam and lab studies, with treatment started on high probability cases. Due to the nature of operations, often sailors were not able to be medivac’d until after symptoms and treatment resolve. We used a 3 drug protocol of ampicillian, cipro, flagyl with excellent results. Most of sailors treated with this protocol, subsequently under went elective appendectomy, due to the nature of submarine operations.
May 7, 2017
Lee Morissette, PA-C, HMCM(SW), USN RetAgreed a great article and the subject of antibiotic use for appendicitis in the United States has been long in coming. As mentioned in the article and posted prior by a reader, fellow PA and former IDC, in the Navy we have long used antibiotics for acute appendicitis treatment, with no significant adverse outcomes. Even if there was a perforation, the patient was stabilized until they could be medevac’d to surgeon. Diagnosis was made on detailed physical exam and a manual CBC as no imaging available on all but larger ships. I personally had several Sailor’s with acute appendicitis that did exceptionally well with the 3 drug regiment previously mentioned.