Appendicitis Medication List

The onset of appendicitis is an urgent problem that needs treatment. Whether you receive surgery (an appendectomy) or not, medication will be administered during treatment.

This article describes how appendicitis medication can be taken alone or with surgery to treat a diseased appendix.

Antibiotic Medication Instead of Surgery

Research indicates that up to 70% of people with appendicitis may benefit from treatment with medication instead of surgery.

Appendicitis treatment without surgery is less risky for adults with uncomplicated appendicitis, with no immediate threat of rupture or other problems. It may also benefit older people for whom surgery carries a higher risk of potential complications.

For Pain

Appendicitis symptoms of pain and infection last until the appendicitis is treated or surgically removed. If you opt for treatment with antibiotics medication instead of surgery, you may need drugs to treat your pain until the antibiotics take effect.

Despite past concerns that the therapeutic effects of analgesics can increase the risk of a diagnostic error, several randomized controlled studies have reported that treating pain with opioids or other analgesics does not affect the accuracy of a diagnosis.

The following medications may help with pain if you are taking antibiotics medication instead of undergoing surgery:

Opioids can relieve severe pain via intravenous (IV) therapy or oral administration. Because they are highly addictive, they are taken for limited periods to avoid developing physical dependence. The following opioids may help to relieve the pain of appendicitis:

• Kadian, MS Contin (morphine)
• Xtampza ER, OxyContin, Dazidox, and others (oxycodone)
• Tylenol with codeine (codeine with acetaminophen)
• Opana (oxymorphone)
• Conzip (tramadol)
• Percocet (oxycodone with acetaminophen)
• Vicodin (hydrocodone with acetaminophen)
  

Non-steroidal anti-inflammatory drugs (NSAIDs) have properties that can reduce pain, inflammation, and fever. They include the following medications:

• Celebrex (celecoxib)
• Advil, Motrin (ibuprofen) 
• Mobic (meloxicam)
• Nalfon (fenoprofen)
• Aleve (naproxen)
• Toradol (ketorolac)
  

Tylenol (acetaminophen) is a non-opioid pain reliever that reduces pain and fevers. Make sure not to go over the maximum dose of 3,600 milligrams a day and to take into consideration the acetaminophen in Percocet (oxycodone with acetaminophen) and Vicodin (hydrocodone with acetaminophen) in that number.

For Infection

Appendicitis occurs due to an appendix obstruction, leading to bacterial overgrowth. Antibiotics treat infections that are confined to the appendix before the appendix ruptures and then spread beyond the organ. The type of antibiotic required depends on the infection's classification, your comorbidities, physiological conditions, and the risk of adverse outcomes.

Though there is no standardized treatment regimen, therapy usually involves 10 days of treatment that includes three to five days of IV therapy, with the remaining days completed with oral medication at home. Common antibiotics for treatment with medication instead of surgery include the following drugs:

For low-risk patients with community-acquired infections:

• Invanz (ertapenem)
• Avelox (moxifloxacin)
• Augmentin (amoxicillin and clavulanate)
• Moxatag (ampicillin)
• Flagyl (metronidazole) with Rocephin (ceftriaxone)
• Flagyl (metronidazole) with Ceftin (cefuroxime)
• Flagyl (metronidazole) with Claforan (cefotaxime)
• Flagyl (metronidazole) with Ciloxan (ciprofloxacin) or Levaquin (levofloxacin)

For high-risk patients with community-acquired or healthcare/hospital-acquired infections:

• Zosyn (piperacillin and tazobactam)
• Recarbrio (imipenem, cilastatin, and relebactam)
• Merrem (meropenem)
• Xerava (eravacycline)
• Flagyl (metronidazole) and Maxipime (cefepime)
• Flagyl (metronidazole) and Fortaz (ceftazidime)
• Flagyl (metronidazole) and Zerbaxa (ceftolozane and tazobactam)
• Flagyl (metronidazole) and Avycaz (ceftazidime/avibactam)
• Cayston (aztreonam), Flagyl (metronidazole), and Firvanq (vancomycin)
  

Appendicitis Medication Combined With Surgery

When acute appendicitis treatment requires surgery, medication can promote healing and prevent infection. The type of medication taken after surgery depends on the type of surgery you had and the severity of appendicitis.

Though antibiotic treatment for appendicitis has gained acceptance as a first-level treatment, cases that involve complicated appendicitis require an appendectomy. Complicated appendicitis describes a condition in which the appendix is perforated or an abscess is present. If the abscess bursts, there is a risk of peritonitis. This is a life-threatening infection in the lining of your abdomen caused by the spread of bacteria from the burst abscess into the abdomen.

An appendectomy can be performed using open surgery or laparoscopy. General anesthesia is used during both types of procedures. The laparoscopic approach typically has a faster recovery time, less post-surgical pain, and smaller incisions than open surgery.

For Pain

Whether your appendectomy is by open surgery or laparoscopic surgery, post-operative pain is common. The type of pain medication you require will vary based on the surgery you receive and the intensity and type of pain you experience.

The following pain-reducing medications (analgesics) are some of the most common for after an appendectomy:

Opioids (may be administered via IV while you recover in the hospital or as oral pills that you take at home):

• Dilaudid (hydromorphone)
• Kadian, MS Contin (morphine)
• Xtampza ER, OxyContin, Dazidox, others (oxycodone)
• Opana (oxymorphone)
• Conzip (tramadol)
• Percocet (oxycodone with acetaminophen)
• Vicodin (hydrocodone with acetaminophen)
  

Non-steroidal anti-inflammatory drugs (NSAIDs):

• Celebrex (celecoxib)
• Advil, Motrin (ibuprofen) 
• Mobic (meloxicam)
• Nalfon (fenoprofen)
• Aleve (naproxen)
• Toradol (ketorolac)
• Zorvolex (diclofenac)
• Tylenol (acetaminophen)
  

After Surgery

In addition to pain medication, your post-surgical treatment may include medication for preventing the spread of infection. Depending on your condition, you may start with broad-spectrum antibiotics before your surgery.

Research has indicated that preoperative antibiotic prophylaxis is effective in decreasing wound infection and abscesses. The most common antibiotics for this are cephalosporin and imidazole derivatives. These medications—usually administered intravenously—include:

• Flagyl (metronidazole)
• Flagyl (metronidazole) and Garamycin (gentamicin)
• Flagyl (metronidazole)and Ciloxan (ciprofloxacin)
• Flagyl (metronidazole) and Claforan (cefotaxime)
• Mefoxin (cefoxitin)
• Piperacil (piperacillin)
• Cefotan (cefotetan)
• Flagyl (metronidazole) and Ceftin (cefuroxime)

For non-perforated appendicitis, preoperative antibiotic treatment is sufficient. However, treatment with post-operative antibiotics for a period of three to five days is considered the standard of care for patients whose appendicitis involved a perforated appendix.

Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America include the following regimens for treating perforated or abscessed appendicitis:

For people with mild-to-moderate severity or perforated or abscessed appendicitis:

• Mefoxin (cefoxitin)
• Invanz (ertapenem)
• Avelox (moxifloxacin)
• Tygacil (tigecycline)
• Timentin (ticarcillin and clavulanic acid)
• Flagyl (metronidazole) and Ancef (cefazolin)
• Flagyl (metronidazole)and Ceftin (cefuroxime)
• Flagyl (metronidazole) and Rocephin (ceftriaxone)
• Flagyl (metronidazole) and Claforan (cefotaxime)
• Flagyl (metronidazole) and Ciloxan (ciprofloxacin)
• Flagyl (metronidazole) and Levaquin (levofloxacin)
  

For high-risk patients or those with severe physiological disturbance, advanced age, or immunocompromised state:

• Primaxin (imipenem and cilastatin)
• Merrem (meropenem)
  
• Doribax (doripenem)
• Zosyn (piperacillin and tazobactam)
• Flagyl (metronidazole) and Maxipime (cefepime)
• Flagyl (metronidazole) and Fortaz (ceftazidime)
• Flagyl (metronidazole) and Ciloxan (ciprofloxacin)
• Flagyl (metronidazole)and Levaquin (levofloxacin)
  

Appendicitis Medication Side Effects

Like all medications, the drugs that treat appendicitis or the pain and/or infection of surgery put you at risk of having certain side effects. The impact can differ due to many factors, such as your unique physical reaction to certain drugs and interactions with other medications. These reactions can range in severity and frequency.

Common side effects of medications for appendicitis include the following symptoms:

Antibiotics

• Allergic reaction
• Skin rash or hives
• Itching
• Anaphylaxis
• Clostridioides difficile (C. diff) infection
• Headache
• Hematuria
• Vaginitis
• Antibiotic resistance

NSAIDs

• Kidney problems
• High blood pressure
• Heart problems
• Fluid retention (swelling around the lower legs, feet, ankles, and hands)
• Rashes

Opioids

• Drowsiness
• Confusion
• Euphoria
• Slowed breathing
  
• Hypoxia
• Drug dependence or addiction

Abdominal Discomfort

Abdominal discomfort and other gastrointestinal (GI) impacts are common side effects of many drugs. Medications trigger stomach pain and other GI problems by altering the physiology of the mucous membrane lining, called the mucosa, that runs through the entire GI tract, including the stomach and small and large intestines.

When the mucosal membrane is altered or damaged, it can trigger gastritis, an inflammation of the stomach lining. The result can cause the following symptoms:

• Blood in the stool
• Blood in the vomit
• Burning feeling in the stomach or the back
• Constipation
• Diarrhea
• Heartburn (indigestion)
• Nausea
• Stomach pain
• Tarry or black stools
  

Is There a 'Best' Antibiotic for Appendicitis?

There isn't one "best" antibiotic for appendicitis. Like all medications, the "best" medication for your condition depends on many factors, including the details of your problem and personal characteristics like your age, medical history, and other medical issues that could affect your treatment.

Researchers who examined antibiotic therapy at 25 U.S. centers reported that antibiotics were not standardized. However, the most common regimens included a combination of the following IV and oral medications:

Initial IV use of one of the following antibiotics for at least 24 hours:

• Invanz (ertapenem)
• Mefoxin (cefoxitin)
• Flagyl (metronidazole) and Rocephin (ceftriaxone)
• Flagyl (metronidazole) and Ancef (cefazolin)
• Flagyl (metronidazole)and Levaquin (levofloxacin)

Oral administration of Flagyl (metronidazole) plus Ciloxan (ciprofloxacin) or Omnicef (cefdinir) for the remainder of the treatment time, for a total of 10 days of IV and oral treatment

Summary

Appendicitis is a severe problem that needs prompt care. Without the right treatment, the damaged organ can rupture and spread germs into your stomach. The result can cause internal damage and threaten your life.

The problem can be treated with antibiotics or surgery, called an appendectomy, to remove the damaged organ. Both options use drugs to prevent the spread of disease and reduce pain. The treatment you receive and the drugs you take can vary.

Your options depend on the threat of organ rupture, the extent of organ damage, and factors like your age and other medical issues. The right treatment can solve the problem and reduce the risk of recurrence.