“Appendicitis doesn’t go from early, acute appendicitis to ‘bursting’ in a matter of a few moments,” says Tracey Childs, MD, who is board-certified in general and colorectal surgery and chief of surgery at Providence Saint John’s Health Center in Santa Monica, California.
Dr. Childs adds that the complexity of your condition can influence what kind of appendicitis treatment you need. While surgery may still be best for most children with appendicitis, people with pre-existing conditions like cardiac or pulmonary concerns may find that antibiotics could suffice, she says.
“There is increasing evidence that some people may be managed with antibiotics alone,” says Jonathan Jennings, MD, a board-certified internist with Medical Offices of Manhattan in New York.
Dr. Jennings says people with chronic conditions like diabetes or heart, liver, or kidney disease, as well as people with multiple conditions or advanced age, have a higher risk of developing complications from surgery. In these cases, non-surgical options like antibiotics could be the safer route.
Which Antibiotics Can Treat Appendicitis?
- ampicillin and sulbactam (Unasyn)
- cefepime (Maxipime)
- cefotetan (Cefotan)
- cefoxitin (Mefoxin)
- ertapenem (Invanz)
- gentamicin (Garamycin)
- levofloxacin (Levaquin)
- meropenem (Merrem)
- metronidazole (Flagyl)
- piperacillin and tazobactam sodium (Zosyn)
If your appendix is ruptured, doctors may also use an intravenous (IV) antibiotic to treat abdominal infection such as peritonitis — a serious infection of the peritoneum membrane that lines your abdominal cavity — after removing your appendix.
Risks of Treating Appendicitis With Antibiotics
Avoiding surgery sounds appealing, but antibiotic-only treatment does come with some risks. Antibiotic side effects and overnight hospital stays for IV antibiotics are some things to keep in mind, says Childs.
Antibiotics could successfully treat uncomplicated acute appendicitis — as in, appendicitis without a ruptured appendix, pus-filled abscesses, or peritonitis — around 80 to 90 percent of the time, says Shelby Reiter, MD, general surgeon for Swedish Surgical Specialists in Edmonds, Washington.
Dr. Reiter adds that studies have also shown that about 30 to 40 percent of these patients could develop recurring appendicitis and end up undergoing appendectomy within the next five years.