Appendicitis: Antibiotics less costly than surgery
There is increasing evidence to use antibiotic therapy rather than surgery for uncomplicated acute appendicitis, say researchers at the Turku University Hospital in Finland. According to the results of the present study, antibiotics have another advantage in this setting: They are the economically superior option.
The randomized controlled APPAC (APPendicitis ACuta) trial included patients with CT-confirmed uncomplicated acute appendicitis, who were randomly assigned to appendectomy (n=273) or antibiotic treatment (n=257). Recorded costs included costs generated by the initial visit and subsequent treatment and costs generated by possible recurrent appendicitis during the 1-year follow-up.
In the appendectomy group, the overall costs to society were 1.6 times higher than the costs in the antibiotic group (€5,989 vs. €3,744). In both groups, productivity losses represented a slightly higher proportion of overall societal costs than all treatment costs together; diagnostics and medicines only played a minor role. Patients in the surgery group were prescribed significantly more sick leave than those in the medication group (17 days vs. 9.2 days; P < 0.001). Even after controlling for age, sex and type of hospital, the operative treatment still generated significantly more costs in all models.
Treating patients with antibiotics for uncomplicated appendicitis incurred lower costs than the surgical approach.