Impact analysis of expanding antibiotic use for treatment of uncomplicated appendicitis without appendicolith

Aim: Approximately 20% of patients with uncomplicated appendicitis receive antibiotics as a first-line treatment; this study explores the impacts of expanding patient uptake of first-line antibiotics for appendicitis treatment. Materials & methods: We model the impacts on the patient, caregiver, payer and total societal costs associated with expanding antibiotics use from 20 to 50% for patients with appendicitis through use of a decision-tree model. Results: Increasing antibiotics uptake to 50% of eligible appendicitis patients is expected to decrease overall societal economic costs by $192 million, and these savings are driven by a $493 million reduction in initial treatment costs. For patients and their caregivers, out-of-pocket costs are expected to decrease by $18 million, appendectomies by 27,410 and missed work hours by 639,682. Conclusion: Increasing national uptake of antibiotics for the treatment of appendicitis may reduce patient, payer and total societal costs with minimal impact to patient health outcomes. An expansion may also decrease the total number of appendectomies, appendectomy-related medical complications, and lost wages for patients and caregivers, with minimal decreases in the number of appendiceal cancer cases treated early.