Acute Appendicitis and Microbiota - Etiology of Appendicitis and Antibiotic Therapy Effects
Status:
Enrolling by invitation
Trial end date:
2025-12-31
Target enrollment:
Participant gender:
Summary
Appendicectomy has been the treatment of acute appendicitis for over a hundred years.
Appendicectomy, however, includes operative and postoperative risks despite being a routine
procedure. Several studies have proved promising results of the safety and efficiency of
antibiotics in the treatment of acute uncomplicated appendicitis. The previous APPAC study by
the investigators, published in 2015 in the Journal of American Medical Association, also
proved promising results with 73% of patients with uncomplicated appendicitis treated
successfully with antibiotics. None of the patients initially treated with antibiotics that
later had appendectomy had major complications. The results of the APPAC trial suggest that
CT proven uncomplicated acute appendicitis is not a surgical emergency and antibiotic therapy
is a safe first-line treatment option. Reducing unnecessary appendectomies has also been
shown to lead to significant economic savings. On the other hand, antibiotic therapies have
been shown to have an effect on the normal gut microbiota and are considered an increasing
global health threat underlining the importance of evaluating both short- and long-term
effects of the antimicrobial treatment in old and new indications.
The aims of this randomized prospective study are:
1. To evaluate the possible role and differences in the microbiological etiology of
complicated and uncomplicated appendicitis.
2. To determine the effects of both antibiotic and placebo treatment on the composition of
gut microbiota, and to evaluate how it recovers after the appendicitis-related
antimicrobial treatment (AMT)
3. To evaluate the effects of the duration of the hospital stay on the AMR reservoir of the
gut microbiota.
Phase:
N/A
Details
Lead Sponsor:
Turku University Hospital
Collaborators:
Helsinki University Central Hospital Jyväskylä Central Hospital Kuopio University Hospital Oulu University Hospital Tampere University Hospital