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November 1, 2017BMJ OpenOpen Access

Initial non-operative management of uncomplicated appendicitis in children: a protocol for a multicentre randomised controlled trial (APAC trial)

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Why the study?

Does non-operative treatment (antibiotics) reduce complications compared to primary appendectomy in children with simple appendicitis?

Population

Children aged 7-17 years with imaging-confirmed simple appendicitis (intended n=334)

Comparison

Non-operative treatment consisting of… vs Primary appendectomy

Design

Other, randomised

Follow-up

1-year

Authors

MKMax KnaapenJLJohanna H. van der LeeRBRoel Bakx

Discussion

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Overview

This protocol outlines a multicenter non-inferiority RCT comparing antibiotics to appendectomy for simple appendicitis in children.

Structured PICO

Does non-operative treatment (antibiotics) reduce complications compared to primary appendectomy in children with simple appendicitis?

P
Population
Children aged 7-17 years with imaging-confirmed simple appendicitis (intended n=334)
I
Intervention
Non-operative treatment (NOT) consisting of intravenous antibiotics for 48-72 hours, daily blood tests, and ultrasound follow-up, followed by oral antibiotics at home
C
Comparator
Primary appendectomy
O
Outcome
Rate of complications at 1-year follow-upsafety

This protocol outlines a multicenter non-inferiority RCT comparing antibiotics to appendectomy for simple appendicitis in children.

Cite This Study

Knaapen et al. (2017) studied this question.

synapsesocial.com/papers/6a8159612bdcf510039cd5a3https://doi.org/10.1136/bmjopen-2017-018145
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Non-operative treatment strategy versus surgery for children with simple appendicitis: non-inferiority randomised controlled trial2026
  2. 2Acute uncomplicated appendicitis study: rationale and protocol for a multicentre, prospective randomised controlled non-inferiority study to evaluate the safety and effectiveness of non-operative management in children with acute uncomplicated appendicitis2016 · 33 citations
  3. 3The clinical and cost effectiveness of a conservative treatment pathway compared to appendicectomy in children with uncomplicated acute appendicitis: study protocol for a randomised controlled multi-centre open-label parallel-group non-inferiority trial (CONTRACT 2 trial) in the United Kingdom (UK)2025 · 2 citations
  4. 4CONservative TReatment of Appendicitis in Children: a randomised controlled feasibility Trial (CONTRACT)2021 · 30 citations
  5. 5NONOPERATIVE TREATMENT FOR ACUTE UNCOMPLICATED APPENDICITIS IN CHILDHOOD2026