A JAMA Network report discusses results from the 10-year follow-up of the APPAC (Appendicitis Acuta) trial, which initially studied antibiotics for uncomplicated acute appendicitis. The follow-up data are presented as long-term evidence that antibiotics can be a feasible treatment option for some patients. In the reported outcomes, patients initially treated with antibiotics have a 37.8% true recurrence rate of appendicitis over 10 years. In addition, the cumulative rate of appendectomy is 44.3% among those initially managed with antibiotics.
At the same time, the JAMA Network correspondence raises questions about how broadly these findings apply and how they should be interpreted. The commentary notes concerns related to generalizability, safety, and practicality of antibiotic-only management for uncomplicated cases, although it does not dispute the reported recurrence and appendectomy figures. Overall, the sources agree that long-term follow-up shows a substantial proportion of patients eventually experience recurrence or require appendectomy after initial antibiotic treatment, while also acknowledging the ongoing role antibiotics may play in selected uncomplicated appendicitis patients.
