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Dr. Andrew Rynne

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Is Cipro appropriate medication for appendicitis?

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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 16512 Questions

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Posted on Wed, 15 Mar 2017 in Medicines and Side Effects
Question: My son was diagnosed with a seeping appendix and the doctors treated him with Cipro. Is this adequate treatment for what I have described?
doctor
Answered by Dr. T Chandrakant 20 minutes later
Brief Answer:
As detailed

Detailed Answer:
Hi.
Thanks for your query, albeit short and specific.
As per the history you have provided, there is a diagnosed appendicitis and kept on Cipro to see if the attack settles or not.
The surgical rules in general are:
If the patient with appendicitis presents later than 3 days of attack and has appendicular lump as felt on examination or seen on CT scan then it is usually treated conservatively by antibiotics and progress seen clinically as well as by improvement in blood counts and CT scan. If there is an improvement then interval appendectomy is done after 6 weeks.
If there is no improvement within 24- 48 hours as by above criteria, surgery may be undertaken.

I hope, this general rule applies for your son and hence can wait and see the results.

Please give some details:
Since when are the symptoms present?
When was Cipro started?
When were investigations done?
Has he improved or not?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. T Chandrakant 35 minutes later
The symptoms were present 2 weeks ago. Severe abdominal pain and vomiting.
Hospitalized and put on Cipro afterCT scan showed leaking appendix. Thayer for 3 days and continued oral Cipro at home for a week.
Went back to work 7 days ago as carpenter on light duty.
Re-visited Doctors this past Thursday. Older MD suggested surgery when appendix healed..Younger MDs suggested Cipro as a treatment for symptoms if they returned.
My son suggested another CT Scan at the end of March,2017 and that showed healing of the appendix the he said "get it out othwise I feel like I'm sitting on a time bomb". What is your opinion? I'm inclined to agree with my son though I didn't voice that. again I'd like your opinion.

What is your opinion of the above?

What is your opinion of the above stated opinions of my son the young doctors compared to that of the more experienced physician who suggested surgery to remove appendix if CT Scan shows no leakage?

What if there are no symptoms and the later CTScan shows healing of the appendix,should as son suggests and surgically remove the problem?
doctor
Answered by Dr. T Chandrakant 4 hours later
Brief Answer:
as explained in details.

Detailed Answer:
I can understand your concern very well.
If you please read the first answer, it tells everything under consideration.
To simplify and to give my opinion as per the surgical principles:
Since the appendicitis occurred 2 weeks ago and has been treated by Cipro and there are no symptoms, the standard practice should be followed.
Get operated after March-end as it will be 6 weeks. By this time the inflammation is under complete resolution, adhesion get separated well so that the ''interval appendectomy'' surgery is easy with best possible results.
As your another MD has said, Cipro to be taken only if there is recurrence of symptoms, which usually does occur.
Even if there are no symptoms and later CT scan shows healing of the appendix, it should be removed as many patients do get recurrence of appendicitis anytime later.
The standard practice is out of the observation of years and years and experience of thousands of surgeons all over the world, hence let us follow the standard practice.

I hope, this clears your doubts.

Above answer was peer-reviewed by : Dr. Prasad
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