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Complex And Simple Appendicitis: REstrictive or Liberal Post-operative Antibiotic eXposure - UCSF

Phase 4
Recruiting
Conditions
Appendicitis
Interventions
Drug: Multiple standard of care antibiotics for appendicitis, at physicians' discretion
Registration Number
NCT05966454
Lead Sponsor
University of California, San Francisco
Brief Summary

The purpose of this study is to demonstrate the safety, efficacy, and feasibility of short-course post-operative antibiotic treatment for simple and complicated appendicitis

Detailed Description

This is a single center, randomized controlled trial to determine if decreasing the amount of antibiotics after appendicitis surgery can decrease the risk of adverse effects associated with antibiotics while at the same time ensuring participant safety.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
145
Inclusion Criteria

Age ≥ 18 years

  • Age ≥ 18 years
  • Planned appendectomy (laparoscopic or open)
  • Working telephone number or reliable method to contact patient after hospital discharge
Exclusion Criteria
  • Unable to consent
  • Pregnant Women
  • Prisoners
  • Immunocompromised as determined by clinical team, or patients actively receiving steroids, chemotherapy, or immunosuppressing medications (for example tacrolimus), or patients with active hematologic malignancy affecting the immune system, leukopenia, or end-stage AIDS
  • Heart failure
  • Allergy to bupivacaine
  • Unlikely to comply with treatment or follow-up
  • Inpatient consultation for appendicitis
  • Clinically suspected of sepsis based on Sepsis-3 definition
  • Current use of antibiotics for other indications
  • Type 1 Diabetes or uncontrolled hyperglycemia
  • Surgeon preference
  • Patient preference
  • Research team unavailable

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Restricted Post-Operative Antibiotics GroupMultiple standard of care antibiotics for appendicitis, at physicians' discretionParticipants undergoing standard of care (SOC) with simple appendicitis will not receive post-operative antibiotics. Participants undergoing standard of care with complicated (gangrenous or perforated) appendicitis will receive up to 24 hours of SOC post-operative antibiotics.
Liberal Post-Operative Antibiotics GroupMultiple standard of care antibiotics for appendicitis, at physicians' discretionParticipants undergoing standard of care with simple appendicitis will receive 24 hours of post-operative SOC antibiotics Participants undergoing standard of care with complicated (gangrenous or perforated) appendicitis will receive 4 days of post-operative SOC antibiotics.
Primary Outcome Measures
NameTimeMethod
Incidence of Infectious/Antibiotic ComplicationsUp to 30 days after appendicitis surgery

Infectious/antibiotic complication requiring antibiotic treatment only, Emergency Department visit, hospital readmission, percutaneous drainage, and operative intervention as assessed by treating physician.

Number of participant deathsUp to 30 days after appendicitis surgery

Up to 30 days after appendicitis surgery

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Zuckerberg San Francisco General Hospital

🇺🇸

San Francisco, California, United States

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