Almost half of children who require surgery for complicated appendicitis can safely complete their recovery at home, according to a new study.

The research, led by Murdoch Children’s Research Institute (MCRI) and published in the Journal of Pediatric Surgery, found more than 40 per cent who received care in the home following a complex appendectomy recovered faster and had fewer complications.

More than 300 patients present with appendicitis to The Royal Children's Hospital (RCH) every year, with about one in three experiencing a burst appendix or severe infection.

The study involved 83 children, aged five to 18 years, admitted to the RCH for a complicated appendicectomy, with 35 suitable for the Hospital in the Home (HITH) program. All patients needed at least five days of intravenous antibiotics (IV) post-surgery. Under the program, a nurse visited the child’s home daily to administer the antibiotics and record clinical observations.

MCRI Associate Professor Penelope Bryant said under this model, patients at home recovered more quickly and didn’t require readmission to hospital.

“Acute post-operative care at home is rare, but we found it’s possible for children to spend 35 per cent less time in hospital after complicated surgery,” she said. "This could be done safely and without prolonging IV courses or broadening antibiotic use."

Image: Associate Professors Penelope Bryant and Warwick Teague. Image credit: Alvin J Aquino

“These findings will help clinicians to identify which children are suitable for HITH care following surgery for complicated appendicitis.”

MCRI Associate Professor Warwick Teague said the HITH program, used heavily during the COVID-19 pandemic, had the added benefits of reduced hospital and family costs, improved quality of life, less time taken from work and prevention of hospital-acquired infections.

“The pandemic presented us with the need and opportunity to deliver care to children in their home,” he said. "This study showed even children who had severe appendicitis can be well cared for at home after surgery, freeing up hospital beds for other sick children and those needing surgery."

“Traditionally after surgery for severe appendicitis, surgeons have insisted on daily reviews in hospital by the surgical team. However, in this study we learnt that optimal postoperative care be delivered at home, by well-trained non-surgical clinicians working as a team with surgeons.”

“For complicated appendicitis, the HITH program also saved over $1,400 per day for the hospital and $300 daily for families, reducing cost-of-living pressures with longer-term benefits for healthcare sustainability.”

Researchers from The Royal Children's Hospital and University of Melbourne contributed to the study.

Publication

Ling Chen, Sebastian King, Misel Trajanovska, Lynda Gaynor, Veronica Cerratti, Rosemary Burgess, Gregory Nolan, Warwick Teague and Penelope Bryant. ‘Getting children home sooner on intravenous antibiotics with a Hospital-in-the-Home model of care for complicated appendicitis,’ Journal of Pediatric Surgery. DOI: 10.1016/j.yjpso.2025.100196

*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.

Available for interview

Associate Professor Warwick Teague, MCRI Clinical Scientist Fellow, Surgical Research

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About Murdoch Children’s Research Institute

Murdoch Children's Research Institute is the largest child health research institute in Australia committed to making discoveries and developing treatments to improve child and adolescent health in Australia and around the world. They are pioneering new treatments, trialling better vaccines and improving ways of diagnosing and helping sick babies, children and adolescents. It is one of the only research institutes in Australia to offer genetic testing to find answers for families of children with previously undiagnosed conditions.

Funding

PB, SK and WT are supported by National Health and Medical Research Council Investigator Grants and Murdoch Children’s Research Institute (MCRI) Clinician-Scientist Fellowships. An MCRI Infection and Immunity Theme Grant supports the study. The Clinical Infections Group and Surgical Research Group at MCRI is supported in part by the Victorian Infrastructure Support Program. This research was in part funded by a grant from The Royal Children’s Hospital Foundation ‘Optimising Antibiotic Use To Reduce Harms in Children’ (RCHF2019-1140). PB is supported in part by an Australian Medical Research Futures Fund fellowship (MRF1197970) and by a MCRI Clinician Scientist Fellowship.