In a groundbreaking study published in the medical journal The Lancet, researchers have explored the possibility of treating acute, non-perforated appendicitis in children with antibiotics instead of surgery.
The study, known as the APPY study, is the first large-scale randomised paediatric trial of its kind, highlighting new opportunities in paediatric surgical care.
Summary of the Study
The APPY study was led from Kansas City and involved 11 children's hospitals from various parts of the world. The research aimed to compare the effectiveness of antibiotic treatment to traditional appendectomy.
The study found that antibiotic treatment is not as effective as surgery due to a higher risk of treatment failure and recurrence. Nonetheless, it emphasised that antibiotics can be a viable option in certain cases, following consultation with children and their parents. One of the advantages of antibiotic treatment is that children can return to their normal lives more quickly.
Swedish Contribution to the Study
A significant part of the study was conducted by researchers from the paediatric surgical research group at Karolinska Institutet in Stockholm. Tomas Wester , Jan F. Svensson , Markus Almström and Elin Öst have spent many years investigating the possibility of treating appendicitis with antibiotics. The group conducted a pilot study that served as the foundation for the APPY study.
Future Research and Questions
The study raises many new questions. There is still reason to believe that some children with appendicitis could be effectively treated with antibiotics and may not even require hospitalisation. Ongoing studies are evaluating whether treatment without antibiotics, using only pain management, might also be effective. Additionally, the team is conducting a study on the quality of life and patient satisfaction among the children included in the APPY study.
