title: Antibiotic therapy for appendicitis in patients aged ≥80 years.
abstract: OBJECTIVE
  Although many patients receive antibiotic therapy for appendicitis, it is unclear if this treatment can be administered to elderly patients. We aimed to assess the outcomes of antibiotic therapy for appendicitis in elderly patients aged ≥80 years.
  
  
  METHODS
  During this 4-year study, we enrolled 26 elderly patients who initially received antibiotic therapy. Of these, 3 were suspected to have complicated appendicitis. Antibiotic therapy consisted of second-generation cephalosporin and metronidazole that was administered for 4 days with a 24-hour fasting period. We evaluated the rates of treatment failure and recurrence.
  
  
  RESULTS
  Mean age was 83.5 years, and 57.7% (15/26) of patients had comorbidities. One patient (4.8%) failed to respond to antibiotic therapy and underwent subsequent appendectomy. During the median follow-up period of 17 months, 5 patients (20%) experienced recurrence; 3 underwent appendectomy and 2 received a new course of antibiotics.
  
  
  CONCLUSIONS
  Antibiotic therapy without surgery may be a safe and effective treatment for appendicitis in selective patients aged ≥80 years. This is a good treatment option in patients with high operative risk.
authors: Department of Surgery, Hallym University College of Medicine, Anyang, Korea.
authors: Hyoung-Chul
authors: HC
authors: Park
authors: Department of Surgery, Hallym University College of Medicine, Anyang, Korea.
authors: Min Jeong
authors: MJ
authors: Kim
authors: Department of Surgery, Hallym University College of Medicine, Anyang, Korea. Electronic address: bshlee@hallym.ac.kr.
authors: Bong Hwa
authors: BH
authors: Lee
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001062:Appendectomy; D001064:Appendicitis / Q000188:drug therapy* / Q000601:surgery; D002511:Cephalosporins / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D008795:Metronidazole
keywords: Aged over 80 years; Antibiotic therapy; Appendicitis; Elderly patients