Which treatment is most commonly used to treat appendicitis?

Most patients with appendicitis in the United States have surgery to take out their appendix. In other countries, patients are often given the option of treatment with 10 days of antibiotics and only have surgery if the medicines do not work. To date, most of the information we have about this option is from studies done in Europe. The CODA Trial is the largest study of treatments for appendicitis ever conducted among adults, and the first large-scale study to look at this question in the US.

If a patient takes antibiotics for appendicitis, will they ever get appendicitis again?

Maybe, but their risk of getting it again is not clear. Most studies have looked at patients up to one year after their diagnosis. In these studies, about 3 out of 4 did not have any more problems with their appendix, while 1 out of 4 were not cured by antibiotics or ended up getting appendicitis again in the future. If appendicitis does come back, previous studies have found that it usually happens within the first few weeks.

CODA is also following participants to see how they feel after their treatment with antibiotics, and CODA results will continue to add to what we know about antibiotic treatment for appendicitis.

How many days are patients in the hospital?

After surgery, most patients go home by the next day. Some stay in the hospital for an extra day or longer. 

If a patient’s appendicitis is treated with antibiotics while they are in the emergency room, they might be able to go home the same day, or they might stay in the hospital for an extra day or two depending on how they feel.

Which treatment will get rid of pain most quickly?

If a patient has surgery, pain from the infected appendix will likely go away immediately after surgery. They will likely have some pain around the cuts, or incisions, that were made on their belly, so they will be sent home with pain medicine to take as needed. In most patients, this pain is minor and goes away within a week.

If a patient has antibiotics in the emergency room, they may get medicines to treat pain and nausea. They will also be sent home with pain medicine to take as needed. 

How many days do patients miss from work?

In one study, patients who were treated with antibiotics (without surgery) required 7 days of sick leave, compared with 11 days of sick leave for patients treated with surgery.