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For patients with CT-confirmed simple appendicitis, antibiotic therapy is a safe, effective, feasible and cost-effective alternative to surgical treatment.
2020 guidelines of the World Society of Emergency Surgery recommend antibiotics as a safe alternative to simple acute appendicitis treatment without appendicitis (high quality of evidence; highly recommended).
also endorsed by the American College of Surgeons during the 2019 Coronary Virus Disease (Covid-19) pandemic, but the most effective antibiotic treatment options are unclear.
researchers recently compared the differences in the efficacy of antibiotic-wide oral programmes and antibiotic injection combined oral programmes in patients with simple appendicitis.
the APPAC II study, an open, multi-center, non-inferior study, was conducted between July 2017 and November 2018, involving 599 CT-diagnosed patients with simple appendicitis, followed by a random seven-day oral treatment of Mosesacin until November 2019 (2019) 400mg/day, n-295) or intravenous ertamine (1g/day, lasts 2 days) followed by oral LOX fluorosastar (500mg/day for 5 days) and methazole (500mg x 3 times/day, lasts 5 days n-288).
of the study was treatment success rate, defined as no surgical discharge and no recurrence of appendicitis during follow-up for 1 year.
599 patients, with an average age of 36 years, 263 women and 99.7% completed one year of follow-up.
treatment success rate of 1 year in the oral antibiotic treatment group was 70.2%, the treatment success rate in the injection combined oral antibiotic treatment group was 73.8%, and the difference between the groups was -3.6%, reaching the non-inferior end point.
study concluded that for CT-diagnosed patients with simple appendicitis, the success rate of 7-day oral treatment of moxisa star and 2 days of otamine intravenous injection combined with 5 days of oral treatment of zoxafluoroxin-methazole was more than 65%, but the success rate of the combined oral treatment of antibiotic injection was higher than that of the full oral treatment.
