Complex appendicitis

Inflammation of the appendix, a.k.a.  “appendicitis”, is a common disease. The standard treatment is surgery to remove the appendix (“appendicectomy”). In 25 – 30% of patients the inflammation is advanced or complex, in which case patients usually receive antibiotic treatment after surgery to lower the risk of an infectious complication (i.e. intra-abdominal abscess).

Antibiotic treatment duration

At the moment there is no consensus on the necessary treatment duration. Most Dutch patients receive antibiotics for 5 days. Literature indicates a shorter duration is as effective and safe, however strong scientific proof is lacking.

Antimicrobial resistance

A consequence of overtreatment with antibiotics is (faster) resistance of bacteria against antibiotics. This is an urging issue worldwide.  To minimalize risk of resistance it is of importance to optimize antibiotic strategy. Possible advantages that may accompany shorter duration of therapy are shorter length of stay in the hospital and lower hospital costs.