Antibiotics may be a good choice for some, but not all, patients with appendicitis, according to results from the Comparing Outcomes of antibiotic Drugs and Appendectomy (CODA) Trial reported today in the New England Journal of Medicine.
“About three in 10 patients in the antibiotic group ultimately underwent an appendectomy within 90 days,” said Dr. David Flum, co-principal investigator and professor and associate chair of surgery at the University of Washington School of Medicine. “There were advantages and disadvantages to each treatment, and patients will value these differently based on their unique characteristics, concerns, and perspectives.”
CODA is the largest-ever clinical randomized trial of appendicitis treatment. At hospitals across 14 states, 1,552 patients with appendicitis consented to participate and were randomized to receive antibiotics first or undergo an appendectomy.
Nearly half of the antibiotics group were discharged from the emergency department and avoided hospitalization for their initial treatment, but