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Comment & Response
February 19, 2019

Long-term Follow-up of Antibiotics vs Surgery for Appendicitis—Reply

Author Affiliations
  • 1Department of Digestive Surgery, Turku University Hospital, Turku, Finland
  • 2Department of Biostatistics, University of Turku, Turku, Finland
JAMA. 2019;321(7):707-708. doi:10.1001/jama.2018.19595

In Reply In the 5-year follow-up of the Appendicitis Acuta (APPAC) trial,1 our main objective was to determine the late recurrence rate of appendicitis after antibiotic therapy for uncomplicated acute appendicitis. The inferiority of antibiotic therapy compared with appendectomy was reported at 1-year follow-up.2 However, fair comparison of these 2 very different treatments needs to include other parameters, such as complications, patient preference, and follow-up over a longer time. The somewhat high appendectomy complication rate was associated with thorough recording of all adverse events and the open surgical approach.