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Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty?

Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty? Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty? Invited Commentary Invited Commentary Appendicoliths, Antibiotic Treatment Failure, and Appendectomy— Is the Glass Half Full or Half Empty? Liane S. Feldman, MD; Lawrence Lee, MD, PhD During the first round of the hockey playoffs in 1994, Patrick pendectomy at 30 days. These data suggest that the presence Roy, the star goaltender for the Montreal Canadiens, was hos- of an appendicolith was the strongest determining factor in pitalized with “early appendicitis.” He categorically refused sur- treatment failure of antibiotics for appendicitis. gery and convinced his surgeons to treat him with antibiotics. However, this increased risk appears to be highest in the first Although he rapidly improved 48 hours only. Additional data now available from the CODA trial reportednodifferencesintherateofappendectomywithorwith- and led the team to victory in Related article the next 2 games, there was out an appendicolith beyond 2 days up to 2 years. Ultimately al- widespread furor about this initial nonoperative manage- most 50% of patients initially treated with antibiotics required 1 5 ment, which was seen as very poor medical judgement. appendectomy by 2 years, regardless of an appendicolith. How- Perhaps the team physicians were ahead http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty?

JAMA Surgery , Volume 157 (3) – Jan 12, 2022

Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty?

Abstract

Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty? Invited Commentary Invited Commentary Appendicoliths, Antibiotic Treatment Failure, and Appendectomy— Is the Glass Half Full or Half Empty? Liane S. Feldman, MD; Lawrence Lee, MD, PhD During the first round of the hockey playoffs in 1994, Patrick pendectomy at 30 days. These data suggest that the presence Roy, the star goaltender for the Montreal Canadiens, was hos- of an...
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Publisher
American Medical Association
Copyright
Copyright 2022 American Medical Association. All Rights Reserved.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/jamasurg.2021.6901
Publisher site
See Article on Publisher Site

Abstract

Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty? Invited Commentary Invited Commentary Appendicoliths, Antibiotic Treatment Failure, and Appendectomy— Is the Glass Half Full or Half Empty? Liane S. Feldman, MD; Lawrence Lee, MD, PhD During the first round of the hockey playoffs in 1994, Patrick pendectomy at 30 days. These data suggest that the presence Roy, the star goaltender for the Montreal Canadiens, was hos- of an appendicolith was the strongest determining factor in pitalized with “early appendicitis.” He categorically refused sur- treatment failure of antibiotics for appendicitis. gery and convinced his surgeons to treat him with antibiotics. However, this increased risk appears to be highest in the first Although he rapidly improved 48 hours only. Additional data now available from the CODA trial reportednodifferencesintherateofappendectomywithorwith- and led the team to victory in Related article the next 2 games, there was out an appendicolith beyond 2 days up to 2 years. Ultimately al- widespread furor about this initial nonoperative manage- most 50% of patients initially treated with antibiotics required 1 5 ment, which was seen as very poor medical judgement. appendectomy by 2 years, regardless of an appendicolith. How- Perhaps the team physicians were ahead

Journal

JAMA SurgeryAmerican Medical Association

Published: Jan 12, 2022

References