Uncomplicated Appendicitis Eligibility Criteria
Placeholder: imaging and labs confirm appendicitis without perforation or abscess.
- Required: CT/US confirmed (placeholder criterion)
- Relative flag: Appendicolith (placeholder criterion)
- Excluded: Perforation (placeholder criterion)
- ~50/50: CODA trial arm split (placeholder statistic)
Imaging confirmation
Placeholder: CT or ultrasound rules out perforation, abscess, or free fluid.
Patient counseling
Placeholder: shared decision-making compares antibiotics versus appendectomy.
Exclusion criteria
Placeholder: complicated cases and appendicoliths lower non-operative success.
IV Antibiotic Initiation
Placeholder: broad-spectrum IV antibiotics start promptly on admission.
- Ceftriaxone+Metro: Typical regimen (placeholder example)
- 1–2 days: IV duration (placeholder statistic)
- 24–48 h: Fever response (placeholder statistic)
- ~50%: Pain score drop (placeholder statistic)
Regimen selection
Placeholder: coverage targets gram-negative and anaerobic gut flora.
Inpatient monitoring
Placeholder: vitals, pain, and white count are checked serially.
Escalation criteria
Placeholder: worsening signs trigger imaging and possible surgery.
Transition to Oral Antibiotics
Placeholder: stable patients switch to oral antibiotics before discharge.
- ~10 days: Total course (placeholder statistic)
- Cipro+Metro: Oral agent (placeholder example)
- Afebrile 24h: Discharge readiness (placeholder criterion)
- ~90%: Adherence rate (placeholder statistic)
Switch criteria
Placeholder: tolerating oral intake and improving symptoms allow switch.
Home course completion
Placeholder: patients complete the remaining oral antibiotic days at home.
Follow-up scheduling
Placeholder: a clinic check confirms resolution after the full course.
Symptom Resolution Monitoring
Placeholder: pain, fever and inflammatory markers are tracked to confirm resolution.
- ~70%: Resolution rate (placeholder statistic (CODA-like))
- ~29%: Failure needing surgery (placeholder statistic within 90d)
- ~7 days: CRP normalization (placeholder statistic)
- ~1 week: Return to activity (placeholder statistic)
Clinical checkpoints
Placeholder: symptom diaries and clinic visits confirm improvement.
Warning signs
Placeholder: recurring pain or fever prompts re-evaluation for surgery.
Lab trend tracking
Placeholder: CRP and white count trends support resolution confidence.
Recurrence Risk Over the Following Year
Placeholder: some patients experience recurrent appendicitis within a year.
- ~30–40%: 1-year recurrence (placeholder statistic (CODA-like))
- 6 months: Most recurrences by (placeholder statistic)
- Considered: Delayed appendectomy (placeholder outcome)
- Higher risk: Appendicolith recurrence (placeholder statistic)
Recurrence timeline
Placeholder: risk accumulates gradually across the 12-month follow-up.
Delayed appendectomy decision
Placeholder: recurrence or persistent risk may prompt elective surgery.
Long-term outlook
Placeholder: most patients avoid surgery after successful antibiotic course.