Surgeons in Southampton are leading a pioneering study into whether or not antibiotics can prevent the need for surgery in children with acute appendicitis.
The condition, which causes the appendix – a small organ attached to the large intestine – to become inflamed due to a blockage or infection, affects mainly children and teenagers.
Appendicitis is currently treated through an operation to remove the appendix, known as an appendicectomy, and it is the most common cause of emergency surgery in children.
However, recent studies among adults with appendicitis have shown antibiotic medication may be as effective as surgery and the majority of adults can avoid an operation altogether.
Now clinicians led by Nigel Hall, a consultant paediatric surgeon at Southampton Children’s Hospital, are undertaking a national study to discover if children could also avoid surgery for the condition.
“Parents whose children have acute appendicitis commonly ask if an operation, which carries all the associated risks, can be avoided but, currently, the answer is no as it is the gold standard treatment,” explained Mr Hall, the study’s chief investigator.
“Recently, however, it has become clear in adults that antibiotics may be as good as an operation for acute appendicitis and we are now very keen to find out if this is also the case for children.”
Before the study is rolled out at multiple sites, Mr Hall and his team in Southampton, along with colleagues at St George’s Hospital in Tooting, Alder Hey Children’s Hospital in Liverpool and Great Ormond Street Hospital, will carry out a year-long feasibility trial which will see children with appendicitis randomly allocated to have either surgery or antibiotic treatment.
Mr Hall, who is also an associate professor of paediatric surgery at the University of Southampton, said: “In our initial trial, we will see how many patients and families are willing to join the study and will look at how well children in the study recover.
“This will give us an indication of how many children we may be able to recruit into a future larger trial and how the outcomes of non-operative treatment compare with an operation.”
The study – known as CONservative TReatment of Appendicitis in Children a randomised controlled Trial (CONTRACT) – is being funded through a £483,000 grant from the National Institute for Health Research Health Technology Assessment Programme and co-ordinated by the University of Southampton’s clinical trials unit in collaboration with the University of Bristol, the University of Liverpool and University College London.
Posted on Thursday 14 July 2016