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Effect of Oral Moxifloxacin vs Intravenous Ertapenem Plus Oral Levofloxacin for Treatment of Uncomplicated Acute Appendicitis

Effect of Oral Moxifloxacin vs Intravenous Ertapenem Plus Oral Levofloxacin for Treatment of... Key PointsQuestionIs treatment with oral antibiotics alone noninferior to a combination of intravenous and oral antibiotics for treatment of computed tomography–confirmed uncomplicated acute appendicitis? FindingsThis multicenter randomized clinical trial included 583 adults with uncomplicated acute appendicitis who were treated with either 7 days of oral moxifloxacin or 2 days intravenous ertapenem followed by 5 days of levofloxacin and metronidazole. Treatment success (discharge from hospital without need for surgery and no recurrent appendicitis within 1 year) occurred in 70.2% who received oral antibiotics alone vs 73.8% of patients who received intravenous followed by oral antibiotics, with the confidence limit of the difference exceeding the noninferiority margin of 6%. MeaningPatients with acute, uncomplicated appendicitis treated with oral antibiotics alone met the prespecified threshold for treatment success, but failed to demonstrate noninferiority relative to systemic antibiotics followed by oral antibiotics. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

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Publisher
American Medical Association
Copyright
Copyright 2021 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2020.23525
Publisher site
See Article on Publisher Site

Abstract

Key PointsQuestionIs treatment with oral antibiotics alone noninferior to a combination of intravenous and oral antibiotics for treatment of computed tomography–confirmed uncomplicated acute appendicitis? FindingsThis multicenter randomized clinical trial included 583 adults with uncomplicated acute appendicitis who were treated with either 7 days of oral moxifloxacin or 2 days intravenous ertapenem followed by 5 days of levofloxacin and metronidazole. Treatment success (discharge from hospital without need for surgery and no recurrent appendicitis within 1 year) occurred in 70.2% who received oral antibiotics alone vs 73.8% of patients who received intravenous followed by oral antibiotics, with the confidence limit of the difference exceeding the noninferiority margin of 6%. MeaningPatients with acute, uncomplicated appendicitis treated with oral antibiotics alone met the prespecified threshold for treatment success, but failed to demonstrate noninferiority relative to systemic antibiotics followed by oral antibiotics.

Journal

JAMAAmerican Medical Association

Published: Jan 26, 2021

References

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