Recent research from a major university medical center is reshaping how doctors think about treating appendicitis. The new findings indicate that many patients may safely receive antibiotic therapy at home instead of immediate surgery, challenging long-standing norms and offering a patient-centered alternative that can fit modern health care needs. The study, published in a respected medical journal, highlights the role of nonoperative management as a viable option for acute appendicitis when careful patient selection and structured follow-up are in place.
The investigation looked at data from 726 people who had imaging-confirmed appendicitis and were treated across 25 medical centers between May 1, 2016 and February 28, 2020. For those assigned to antibiotics, the initial phase involved intravenous therapy, with discharge from the emergency department often occurring within 24 hours. After leaving the hospital, roughly 46 percent of these patients continued their recovery with oral antibiotics at home. A year after treatment, outpatient management showed a very low rate of serious adverse events, with fewer than one event per 100 patients occurring in the first week after discharge. These results suggest that home-based antibiotic regimens can be safe and effective under close clinical supervision and timely access to follow-up care.
In comparing outpatient antibiotic therapy to surgical management, researchers found that both groups regained daily activities, work, and schooling at similar rates. The avoidance of hospitalization and anesthesia-related risks, along with the potential to reduce inpatient resources, adds to the appeal of nonoperative care for suitable patients. There was a small difference in lost workdays between the antibiotic and surgery groups—about 2.8 days versus 2.6 days—yet this gap does not clearly indicate a meaningful difference in overall recovery when viewed over the longer term. The researchers stress that outpatient antibiotic therapy can be a reasonable option for many individuals presenting with appendicitis, provided they are carefully chosen and receive appropriate follow-up care. This approach also holds promise for lowering health care costs, reducing exposure to surgical risks, and alleviating emergency department crowding and postoperative complications. With rare exceptions that require rapid surgical intervention, the data support nonoperative treatment as part of a broader, patient-focused strategy for managing acute appendicitis.