The APAC trial is a randomized controlled trial where children aged 7 to 17 years with simple appendicitis are randomized between the standard treatment: appendectomy, which is the surgical removal of the appendix, and an experimental treatment with antibiotics. Our hypothesis is that antibiotic treatment in children with simple appendicitis is non-inferior to surgery. The antibiotic treatment involves a 2-day hospital stay with intravenous antibiotics, followed by several days of oral antibiotics.
Progress
Recently, the inclusion phase of the trial successfully concluded after 7 years in the 14 participating hospitals in the Netherlands. These 302 children will be followed for a year to investigate the outcomes. Important outcomes we consider include the rate of failure of antibiotic treatment during the initial hospitalization, necessitating surgery. We are also interested in the rate of recurrent appendicitis within a year after the initial successful antibiotic treatment. Furthermore, we will examine the impact on health-related quality of life and associated costs.
Prospects
By the end of this year, the final follow-up will be completed, and we can begin analyzing the promising results. We aim to demonstrate that antibiotics can be a well-considered alternative to surgery for children with simple appendicitis.
