Patient perspectives on antibiotics for appendicitis at one hospital

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• 作者：Samantha P. Kadera ; MD ; MPH^a ; ^{skadera@mednet.ucla.edu" class="auth_mail" title="E-mail the corresponding author} ; William R. Mower ; MD ; PhD^a ; Anusha Krishnadasan ; PhD^b ; David A. Talan ; MD^a ; ^b
• 关键词：Appendicitis ; Appendectomy ; Antibiotics ; Survey
• 刊名：Journal of Surgical Research
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：201
• 期：2
• 页码：253-257
• 全文大小：515 K

文摘

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.