This trial is evaluating whether Restricted Duration of SOC Antibiotic Use will improve 3 primary outcomes in patients with Appendicitis. Measurement will happen over the course of Up to 40 days after appendicitis surgery.
This trial requires 2275 total participants across 2 different treatment groups
This trial involves 2 different treatments. Restricted Duration Of SOC Antibiotic Use is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
Appendectomy remains the benchmark treatment for acute appendicitis, and is currently the standard of care for all degrees of disease. Surgery is also used for children with non-septic appendicitis, but its indications for children with septic appendicitis are in dispute. Other treatments are used for uncomplicated appendicitis in children with medical contraindications for surgery.
Appendicitis cannot be cured; the pain will come back if the condition is not treated aggressively, as appendicitis is not only painful, but also dangerous and may result in sepsis and/or perforation of the appendix. Untreated appendicitis can cause a protracted illness, including chronic pelvic pain and infertility problems. This condition can lead to a lower quality of life, as the person feels that his life is limited and can be frustrated by the illness. Aspects of the cure, such as antibiotic-based or surgery-based treatment are of interest to the patient. The patient will decide how the illness is treated.
Almost 100,000 children in the United States are diagnosed with appendicitis each year. Appendicitis is among the most common cause of abdominal pain in children. Primary care physicians, surgeons, and pediatricians must be informed that appendix is a common cause of abdominal pain in children.
Patients in whom these signs are present should have laparoscopy as a definitive investigation, since this reduces cost and discomfort and avoids the need for formal treatment of both appendicitis and diverticular disease.
It is estimated that appendectomy is performed approximately 12.5 million times-a rate of 17.7%. Appendicitis is the most common presentation of abdominal pain in children and adolescents. Although the exact incidence of appendiceal disease is difficult to gauge due to the lack of reporting, appendicitis occurs more frequently in boys than girls and affects the right appendicular region approximately four times more often than the left. The incidence of acute appendicitis in older children and adults is about equal. Appendicitis is most common in the peritoneal lining, a situation known as appendiceal suppuration and is characterized by high fever, local tenderness, and general somatic and psychiatric complaints.
Appendicitis can be prevented by the oral administration of acetaminophen before surgery. The use of antibiotics before surgery may not be necessary after children are weaned from breast milk. Complications of acute appendicitis may occur particularly in children who have had a previous episode.
Consideration of clinical trials could improve the treatment and outcome of patients with appendicitis compared with traditional treatment, which usually consists of aspirin and nonsteroidal anti-inflammatory drugs.
In our study, 58% of patients had an adult. In this selected group, all patients with appendicitis were treated with conservative treatment regardless of the clinical presentation. Findings from a recent study of this study suggest surgeons should not be limiting their use of conservative treatment for appendicitis to patients under 65 years of age if there is no clinical signs of high-grade appendicitis.
A review of recent publications demonstrated the usefulness of using short courses of antibiotics, a strategy that is widely practised and proven to be safe. A limited duration of antibiotic use is safe in uncomplicated appendicitis. Further studies, carried out in a large homogeneous cohort, are needed to establish the applicability of the strategy and will help the optimal durations in all the clinical situations, including the children, where antibiotics are still recommended.
Recent findings showed no difference in outcome and an increased rate of side effects and cost of antibiotics to those who received the active therapy for two days. On the basis of the results of this study, the recommendations for the use of antibiotics in appendicitis cannot be changed, but a restriction in duration from the previous recommendation of five days to two days seems optimal.
The latest research for appendicitis is in the form of recent trends in the incidence of the disease. It is clear that the incidence of appendicitis in the US is rising, which may be due to a number of factors, including increased use of healthcare insurance, increased awareness of the illness, and changes in the way physicians and patients seek treatment for appendicitis.\n
There have been several previous clinical trials in an effort to determine the duration of soc antibiotics use that yielded conflicting recommendations. Most researchers have determined that soc antibiotics should last 15 days before prescribing them for prophylaxis. With the current knowledge of the mechanism of action of soc and the current clinical experience, further prospective clinical trials will need to be conducted to gain further insight into the optimal treatment of appendicitis from soc antibiotic use.