Randomised controlled trialindependent cross-checkabstract only checked I-ORG-08 standard review

Finland: antibiotics for appendicitis after 5 years

Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial.

Overview

Salminen P et al.. JAMA 2018 · PMID 30264120 · DOI 10.1001/jama.2018.13201

About 61% treated with antibiotics never needed their appendix removed in 5 years.

Does the study support the specific claim? Partly · Methodological quality: high

Study explained simply

What did the researchers want to find out?: Long-term
How was the study done?: RCT follow-up
How many people, animals or samples were studied?: 530
What was actually found?: 39.1% recurrence
How large was the observed effect?: 39.1%
What do the results mean in everyday life?: Many can avoid surgery
What are the study's limitations?: Open surgery comparator
What does it say about Elawady's specific claim?: Partly supports
Do the results apply to Germany and Europe?: European
What can explicitly not be concluded from this study?: Complicated appendicitis

Late recurrence after antibiotic treatment

Results: Cumulative recurrence 39.1% at 5 years; complications 24.4% after appendectomy vs 6.5% antibiotics.
Absolute risks: not reported
Authors' conclusion: Supports feasibility of antibiotics alone for uncomplicated appendicitis.

Supports C-ORG-17 (appendectomy not always necessary for uncomplicated cases).

Directly European.

Supports antibiotic option.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	high
Risk of bias	some concerns
Precision of results	moderate
Directness	direct
Reproducibility	replicated
Consistency with the overall evidence	consistent
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable