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.
JAMA – American Medical Association
Published: Jan 26, 2021
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