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Antibiotic therapy for appendicitis in patients aged ≥80 years
Hyoung-Chul Park1, Min Jeong Kim1, Bong Hwa Lee1
1Department of Surgery, Hallym University College of Medicine, Anyang, Korea.
The American Journal of Medicine
|February 8, 2014
Summary
Antibiotic therapy for appendicitis shows promise in elderly patients aged 80 and above. This approach may be safe and effective, especially for those with high operative risks.
Area of Science:
- Geriatric Medicine
- Surgical Gastroenterology
Background:
- Antibiotic therapy is common for appendicitis, but its use in elderly patients is not well-established.
- Elderly patients often have comorbidities, increasing surgical risks.
Purpose of the Study:
- To evaluate the outcomes of antibiotic therapy for appendicitis in patients aged 80 years and older.
- To determine the safety and efficacy of non-operative management in this demographic.
Main Methods:
- A 4-year study involving 26 elderly patients (≥80 years) treated with antibiotics.
- Antibiotic regimen: second-generation cephalosporin and metronidazole for 4 days with 24-hour fasting.
- Evaluation of treatment failure and recurrence rates.
Main Results:
- Mean patient age was 83.5 years; 57.7% had comorbidities.
- Low treatment failure rate (4.8%, 1/26) requiring appendectomy.
- Recurrence rate of 20% (5/26) over a median 17-month follow-up.
Conclusions:
- Antibiotic therapy alone appears to be a safe and effective option for select elderly patients with appendicitis.
- This non-surgical approach is particularly beneficial for patients with high operative risk.
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