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The randomized CODA trial of U.S. patients with appendicitis showed that antibiotics were noninferior to appendectomy (according to quality-of-life scores at 30 days), albeit with a 30-day appendectomy rate of about 16% for those treated initially with antibiotics (NEJM JW Gen Med Dec 1 2020 and N Engl J Med 2020; 383:1907). For the antibiotic group, the protocol specified initial intravenous antibiotics followed by various oral regimens (total course, 10 days) and allowed patients to be discharged from the emergency department or hospital within 24 hours if they appeared to be clinically stable. In this secondary analysis, researchers examined the safety of early discharge.
Among the 726 patients who received antibiotics, researchers found …