The following is a summary of “Short Postoperative Intravenous Versus Oral Antibacterial Therapy in Complicated Acute Appendicitis, A Pilot Noninferiority Randomized Trial” published in the February 2024 issue of Surgery by Lipping, et al.
For a study, researchers sought to find out if giving drugs by mouth after surgery for difficult appendicitis is better or worse. In recent studies that compare the results of antibacterial treatment after surgery for difficult appendicitis, antibiotics were only given intravenously. They thought oral antibacterial treatment would have the same or better results in surgical infectious problems as IV treatment.
In the pilot, open-label, prospective randomized trial, all adult patients with complicated appendicitis between November 2020 and January 2023 were randomly assigned to receive antibiotics through an IV for 24 hours or by mouth for 24 hours after an appendectomy. This included patients with gangrenous appendicitis, perforated appendicitis, and appendicitis with perpendicular abscesses. The main results were problems 30 days after surgery, as measured by the Comprehensive Complication Index. The time of stay in the hospital was the second result. As planned and according to procedures, a follow-up study was done after 30 days.
About 104 patients were entered, with 51 given IV treatment for 24 hours and 53 given mouth treatment for 24 hours. The study groups had similar demographics and scores for how bad the acute appendicitis was. There were no big changes between the study groups regarding problems 30 days after surgery. There was no difference in the median Comprehensive Complication Index between the study groups. Both groups spent about the same amount of time in the hospital. The results of this small randomized controlled study showed that giving antibiotics by mouth for 24 hours had the same or better results than giving antibiotics intravenously for 24 hours after a laparoscopic appendectomy for complex appendicitis.
