JAMA

Antibiotic strategy holds up long term in appendicitis, trial shows

January 22, 2026

A decade-long observational follow-up of the Appendicitis Acuta (APPAC) trial (NCT01022567) assessed adults with CT–confirmed uncomplicated appendicitis initially treated with antibiotics. Among 253 patients evaluated at 10 years, the true recurrence rate—defined by histopathology—was 37.8%. Cumulative appendectomy rate reached 44.3%. Patients randomized to surgery had a higher cumulative complication rate over 10 years (27.4%) than those treated with antibiotics (8.5%). Quality‑of‑life scores were similar between groups.

Clinical takeaway: Antibiotic treatment is a durable alternative to immediate appendectomy, with predictable long-term recurrence and fewer complications.

Source:

Salminen P, et al. (2026, January 21). JAMA. Antibiotic Therapy for Uncomplicated Acute Appendicitis: Ten-Year Follow-Up of the APPAC Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/41563747/