A study published in the Journal of the American College of Surgeons (JACS) highlights that treating uncomplicated appendicitis in children with antibiotics alone can be a cost-saving and effective alternative to surgery. Appendicitis is one of the most common reasons for pediatric hospitalization in the U.S., with appendectomy being a frequent and costly procedure.
The study, led by Dr. Peter C. Minneci from Nemours Children’s Health, analyzed data from over 1,000 patients aged 7 to 17 treated at Midwest hospitals between 2015 and 2018. Families were given the choice of nonoperative management—at least 24 hours of intravenous antibiotics—or urgent laparoscopic appendectomy. Patients whose symptoms persisted underwent surgery during the same admission.
Results showed that the antibiotics-only approach was both less expensive and more effective over one year. The average cost for surgery was $9,791 with a quality-adjusted life year (QALY) score of 0.884, while nonoperative management averaged $8,044 with a slightly higher QALY score of 0.895. Nonoperative management also resulted in fewer disability days and higher patient-reported quality-of-life scores.
Dr. Minneci emphasized that this approach offers not just safety and effectiveness but also cost-effectiveness. The study suggests that nonoperative management could serve as a reasonable alternative to surgery for children with uncomplicated appendicitis.
As reported by medicaldialogues, the researchers plan to explore the cost-effectiveness of outpatient antibiotic management and same-day discharge for laparoscopic appendectomy. However, they noted limitations such as the study’s one-year follow-up period and its focus on children’s hospitals in the Midwest, which may not fully generalize to other populations.