The results of the study were published in the ‘New England Journal of Medicine’.
âIn the first three months after taking antibiotics for the disease, almost 7 out of 10 patients in the antibiotic group avoided an appendectomy. In four years, just under 50% had the surgery,â said Dr. David Flum, Co-Principal Investigator and Professor and Associate Chairman of Surgery at the University of Washington (UW) School of Medicine.
“Other results favored either antibiotics or surgery. Overall, antibiotics appear to be the right treatment for many patients with appendicitis, but probably not all,” added Dr Flum.
CODA is the largest randomized clinical trial ever for the treatment of appendicitis. In 25 hospitals in 14 states, 1,552 patients with appendicitis consented to participate and were randomized to receive antibiotics or have an appendectomy.
âWhile there have been pros and cons to each treatment, we have found that both treatments are safe, and patients will likely appreciate that these results differ depending on their unique symptoms, concerns, and circumstances,â said Flum.
Patients with appendicolith, a calcified deposit found in about 25 percent of cases of acute appendicitis, were associated with more complications and a higher risk of appendectomy within the first 30 days. At 90 days, however, there was no greater chance of appendectomy in patients with appendicolith.
“In light of these results and the new treatment guidelines, it is important for surgeons and patients to discuss the pros and cons of surgery and antibiotics to decide which treatment is best for that person at this time. “said Dr. Giana Davidson. She is Associate Professor of Surgery at UW and Director of the CODA Trial Clinical Coordination Center.
To foster these conversations, CODA researchers created an online decision-making tool for patients. It includes a video (currently in English and Spanish, with more languages ââto come) and a mechanism to help patients choose a direction that may best suit their individual situation.
âIn an emergency, patients with appendicitis may make a treatment decision in a hurry,â Davidson said.
âThis online tool was designed to help communicate the results of CODA in layman’s terms and to stimulate a conversation between patients and surgeons about the potential advantages and disadvantages of each approach,â Davidson concluded.