Patient perspectives on antibiotics for appendicitis at one hospital

Abstract Background Appendicitis has long been considered a progressive inflammatory condition best treated by prompt appendectomy. Recently, several trials comparing initial treatment with antibiotics alone to appendectomy suggest that antibiotic therapy may be a safe option in select patients. How...

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Bibliographic Details
Published in:The Journal of surgical research 2016-04, Vol.201 (2), p.253-257
Main Authors: Kadera, Samantha P., MD, MPH, Mower, William R., MD, PhD, Krishnadasan, Anusha, PhD, Talan, David A., MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Antibiotics
Appendectomy
Appendectomy - psychology
Appendicitis
Appendicitis - drug therapy
Appendicitis - surgery
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Patient Preference - statistics & numerical data
Prospective Studies
Surgery
Survey
Young Adult
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Summary:Abstract Background Appendicitis has long been considered a progressive inflammatory condition best treated by prompt appendectomy. Recently, several trials comparing initial treatment with antibiotics alone to appendectomy suggest that antibiotic therapy may be a safe option in select patients. However, little is known about patients' understanding of appendicitis, prioritized outcomes, and treatment preferences. Materials and methods We conducted a prospective, observational survey at a Los Angeles County public hospital emergency department. Trained study coordinators recorded the following data on each subject: basic knowledge of appendicitis, past surgical and antibiotic history, and medical illness outcome priorities. Participants were then educated about appendicitis and were told that studies had demonstrated that appendicitis can be treated safely with antibiotics alone. Subjects were then surveyed as to their preference for urgent surgery or antibiotics alone in a hypothetical scenario of acute uncomplicated appendicitis. Results Of 129 subjects interviewed, 56 (43%) correctly defined appendicitis, and 69 (53%) identified the treatment for appendicitis as surgery. When presented with a hypothetical acute appendicitis scenario, 57% chose antibiotics over surgery. Persons with previous appendectomy and parents of minors more often chose antibiotics alone, 74% and 63%, respectively. Dying was the most frequently cited and highest-ranked concern about medical illness. Conclusions Our results demonstrate that, among persons at one US public hospital, understanding of appendicitis is poor. Once presented with background information about appendicitis and being informed that antibiotics can safely treat appendicitis, many people would prefer an antibiotic approach over appendectomy. Death is the most prioritized concern.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2015.11.016