Related Experiment Video

Updated: Jul 15, 2025

Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
03:42

Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis

Published on: March 15, 2024

576

Short Postoperative Intravenous Versus Oral Antibacterial Therapy in Complicated Acute Appendicitis: A Pilot

Edgar Lipping1,2, Sten Saar1,2, Arvo Reinsoo1,2

  • 1Division of Acute Care Surgery, North Estonia Medical Centre, Tallinn, Estonia.

Annals of Surgery
|September 25, 2023
PubMed
Abstract

Insights

Postoperative oral antibiotics are noninferior to intravenous antibiotics for complicated appendicitis. This pilot study found similar complication rates and hospital stays, supporting oral administration as a viable alternative.

Area of Science:

  • Surgical Infectious Diseases
  • Clinical Pharmacology
  • Gastrointestinal Surgery

Background:

  • Current practice often favors intravenous antibiotics post-appendectomy for complicated appendicitis.
  • Limited research compares oral versus intravenous antibiotic efficacy in this patient group.
  • Hypothesis: Oral antibiotics yield comparable outcomes to intravenous therapy regarding infectious complications.

Purpose of the Study:

  • To evaluate the noninferiority of postoperative oral antibiotic administration.
  • To compare oral versus intravenous antibiotic regimens in complicated appendicitis management.
  • To assess infectious complications and hospital stay duration.

Main Methods:

  • Pilot, open-label, prospective randomized controlled trial.
  • Adult patients with complicated appendicitis (gangrenous, perforated, abscess) were randomized.
  • Comparison of 24-hour intravenous vs. 24-hour oral antibiotic administration post-appendectomy.

Main Results:

  • 104 patients enrolled; 51 (IV) and 53 (oral) completed treatment.
  • No significant differences in 30-day postoperative complications (Comprehensive Complication Index).
  • Hospital length of stay was comparable between intravenous and oral groups.

Conclusions:

  • 24-hour oral antibiotic administration is noninferior to intravenous therapy.
  • Oral antibiotics represent a safe and effective alternative for complicated appendicitis.
  • Supports a potential shift towards oral antibiotic use post-appendectomy.

More Related Videos

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients03:47

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

Published on: October 25, 2024

264
Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis04:01

Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis

Published on: September 8, 2022

2.5K

Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
91
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
15
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
131
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
106
Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
212
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
164