- Antibiotic treatment for uncomplicated pediatric appendicitis is not only safe but also cost-effective.
- A comprehensive study of over 1,000 cases revealed that the cost of antibiotics was $8,044, compared to $9,791 for surgery.
- While further research is planned, the researchers acknowledged limitations such as regional data and short follow-up duration.
SALT LAKE CITY — A recent study published in the Journal of the American College of Surgeons suggests that treating uncomplicated acute appendicitis in children with antibiotics alone is not only safe but also more cost-effective than opting for surgery.
According to the National Institutes of Health, appendicitis ranks as the fifth leading cause of hospitalization among children, with appendectomy being the most common surgical procedure performed on hospitalized children. Prior research has already established the safety of treating uncomplicated appendicitis cases with antibiotics alone.
The latest study aimed to determine whether this approach is also cost-effective, given that appendectomy is among the most expensive procedures performed during children’s hospital stays.
“Antibiotics have already shown their effectiveness in treating uncomplicated appendicitis,” stated Dr. Peter C. Minneci, head of the surgery department at Nemours Children’s Hospital in Wilmington, Delaware, and co-author of the study. “Our cost analysis now shows that nonoperative management for pediatric uncomplicated acute appendicitis is the most cost-effective strategy over one year, compared to upfront surgery.”
Comparing Surgery and Antibiotics
The researchers examined the costs by analyzing data from over 1,000 patients, aged 7 to 17, who were admitted for acute appendicitis to hospitals across the Midwest from 2015 to 2018. All cases were uncomplicated.
Parents were given the choice between a minimum of 24 hours of antibiotic treatment or surgery for their children. If antibiotics proved ineffective, a laparoscopic appendectomy was performed during the same hospital stay.
The study compared costs by dividing the cost by the charges for the hospitalization, readmissions, and unplanned emergency room visits using data from the Public Health Information System. The study captured data from approximately 50 children’s hospitals.
Researchers also collected patient-reported data on school absences and pain levels at 30 days and one year post-treatment. Quality of life data was also converted into data points. Ultimately, they determined the safety and cost-effectiveness of treating with antibiotics alone on a scale from zero (death) to one (perfect health).
Out of 1,068 patients, 370 were treated with antibiotics, while 698 underwent laparoscopic appendectomy.
The average cost per patient for surgery was $9,791 with a 0.884 quality-adjusted life year score, compared to $8,044 and a 0.895 quality-adjusted life year score for those treated with antibiotics alone.
The researchers plan to conduct further studies, including examining the outcomes of same-day discharge in both treatment groups.
They acknowledged certain limitations, such as the short follow-up period of just one year and the regional focus on the Midwest, which may not reflect the situation across the entire country.
Agree – Antibiotics can be a more cost-effective and less invasive option for treating appendicitis in children, reducing the need for surgery and potential complications.
Agreed – Using antibiotics instead of surgery can be a beneficial and cost-effective alternative for treating appendicitis in children.
Agree – Antibiotics as a substitute for surgery in children with appendicitis can save on costs and reduce potential risks associated with invasive procedures.
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