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2 days versus 5 days of postoperative antibiotics for complex appendicitis: a pragmatic, open label, multicentre, non-inferiority randomised trial.

De Wijkerslooth EML, Boerma E-JG, van Rossem CC, van Rosmalen J, Baeten CIM, Beverdam FH et al, for the APPIC Study Group.

Lancet 2023; 401: 366-376.

Some 1066 patients were included; 95% had a laparoscopic appendicectomy. The rate of postoperative infection or death within 90 days was similar after two (10 per cent) and five days of antibiotics (8 per cent; risk difference 2 per cent, 95 per cent confidence interval-1.6 to 5.6 per cent). Readmission to hospital was more common after the two day course: 12 versus 6 per cent).

Comment: Very useful pragmatic trial that will assist decisions made in all acute hospitals, and significantly reduce antibiotic use.

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