Antibiotics vs Surgery in Acute Appendicitis

March 19, 2026 updated by: Sebahattin Celik MD

Comparison of Antibiotic Therapy and Surgery in the Management of Acute Appendicitis

The aim of this study is to identify clinical, laboratory, and imaging parameters that can predict the most appropriate treatment strategy in patients diagnosed with acute appendicitis. Although appendectomy remains the gold standard treatment, selected patients may be successfully treated with antibiotic therapy. Therefore, determining which patients are more likely to benefit from surgical treatment and which may be managed with antibiotics represents an important clinical challenge.

This study is designed as a single-center prospective observational study. Patients aged 18 years and older who are diagnosed with acute appendicitis between 2024 and 2025 will be included. Demographic characteristics, diagnostic modalities, laboratory parameters, clinical scoring systems (Ohmann score and Alvarado score), imaging findings, and treatment modality (antibiotic therapy or appendectomy) will be prospectively recorded.

Patients treated with antibiotics will be followed to determine whether appendectomy becomes necessary later and to evaluate the time interval between diagnosis and surgery. Patients with other causes of acute abdomen or those with incomplete clinical data will be excluded from the study.

The primary aim of the study is to determine parameters that can predict treatment selection and clinical outcomes. Sensitivity, specificity, and predictive values of the evaluated parameters will be calculated to assess their usefulness in guiding treatment decisions.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

400

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Van, Turkey (Türkiye)
        • Health Sciences University, Van Education and Research Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age ≥18 years
  • Diagnosis of acute appendicitis
  • Patients managed either with antibiotic therapy or appendectomy
  • Availability of clinical, laboratory, and imaging data

Exclusion Criteria:

  • Age <18 years
  • Presence of another cause of acute abdomen (e.g., ovarian torsion, gastrointestinal perforation, etc.)
  • Patients who did not receive either antibiotic therapy or surgical treatment (treatment refusal)
  • Patients hospitalized for another primary medical condition
  • Patients receiving antibiotics for another infection at the time of diagnosis
  • Incomplete or inaccessible clinical data

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Antibiotic Therapy
Patients with acute appendicitis treated with antibiotic therapy without immediate appendectomy.
Drug: Antibiotic
Antibiotic therapy administered for the treatment of acute appendicitis according to current clinical guidelines.
Active Comparator: Appendectomy
Patients diagnosed with acute appendicitis who undergo surgical appendectomy as the primary treatment.
Procedure: surgery (any volume) and / or pharmaceuticals treatment initiated or planned or only dynamic observation, in accordance with current clinical guidelines
Surgical appendectomy performed according to clinical guidelines

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Treatment success of the initial management strategy
Time Frame: Up to 1 years follow-up

Treatment success is defined as the proportion (%) of patients who achieve resolution of acute appendicitis without the need for additional surgical or interventional procedures during the follow-up period.

For patients treated with antibiotics, success is defined as the resolution of clinical symptoms (abdominal pain, fever), normalization of inflammatory markers (white blood cell count, C-reactive protein), and no requirement for appendectomy.

For patients treated with appendectomy, success is defined as the completion of surgery without major postoperative complications (Clavien-Dindo grade ≥ III) and no need for reintervention.
Up to 1 years follow-up

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Need for delayed appendectomy
Time Frame: Up to 1 years
Proportion of patients initially treated with antibiotics who subsequently require appendectomy.
Up to 1 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sebahattin Celik MD

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 4, 2024

Primary Completion (Actual)

November 4, 2025

Study Completion (Estimated)

November 4, 2026

Study Registration Dates

First Submitted

March 13, 2026

First Submitted That Met QC Criteria

March 19, 2026

First Posted (Actual)

March 25, 2026

Study Record Updates

Last Update Posted (Actual)

March 25, 2026

Last Update Submitted That Met QC Criteria

March 19, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024-050674

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Acute Appendicitis

Clinical Trials on Antibiotic

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Luxembourg

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe