In February of 2020, researchers across the United States concluded the largest appendicitis trial to date whose purpose was to evaluate the use of antibiotics as a potentially effective treatment for the condition. Appendicitis is characterized by inflammation and/or infection of the appendix, a finger-like projection of the early large intestine that can become obstructed due to swelling or mechanical blockage. Since the appendix may ultimately rupture if left untreated, it is common and traditional practice that the structure is surgically removed through a laparoscopic appendectomy. In this randomized trial named Comparing Outcomes of Antibiotic Drugs and Appendectomy (CODA), scientists compared the treatment of 1,552 patients with appendicitis who received either surgery or a 10-day course of antibiotics. Their results showed that 70% of patients who received antibiotics were able to avoid surgery, while 30% eventually required appendectomies. These patients missed less time from their vocations, such as work and school, but they ultimately spent more time in the hospital overall than those in the surgery treatment group. Although the researchers intended to publish data for each patient one year posttreatment, they elected to limit this range to 90 days due to the potential implications of the study in light of the Covid-19 pandemic. During a time when patients may feel uncomfortable with spending extended periods of time in the hospital, such as when undergoing and recovering from surgery, the emergence of antibiotics as a viable treatment for illnesses such as appendicitis could be of widespread use. Not only would it benefit patients as a less invasive and more convenient treatment option, but it would also preserve hospital and inpatient resources. While the CODA trial has indicated that antibiotics were just as successful short-term as surgery for the majority of its participants, the decision to use antibiotics for appendicitis must be evaluated together with other factors on a patient-to-patient basis for the best and safest result. More information about CODA can be found here.
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