Antibiotics Versus Surgery in Acute Appendicitis

Antibiotics vs.Surgery in Acute Appendicitis;an Intention to Treat Prospective Randomised Study. The ASAA-study

The acute appendicitis (AA) is a very common disease with a life time risk 7-8% and the highest incidence in the second decades . The aetiology of AA is still poor understood: the commonest hypothesis refers to appendix obstruction followed by impairment of wall appendix barrier and thus wall perforation and/or abscess formation1. However some studies suggest that no-complicate and complicate appendicitis are different entities allowing a different treatment. The study aims to test the no inferiority in terms of efficacy of antibiotic treatment compared to surgery in a population with high probability to suffer of 1st episode of AA.The study aims to test the no inferiority in terms of efficacy of antibiotic treatment compared to surgery in a population with high probability to suffer of 1st episode of AA.

Inclusion Criteria:

• patients between 18 and 65 years old
• first episode of suspected AA diagnosed by Andersson's score or combination with abdominal ultrasound

Exclusion Criteria:

• patients with any potential immunodeficiency status
• assumption of antibiotics for different infectious disease or surgery in the last 30 days
• allergy to antibiotics established in the study protocol
• no acceptance of study protocol
• pregnancy or delivery in the last 6 months
• ASA IV or V, no Italian or English fluently speakers.