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In recent trials, researchers have explored antibiotic therapy for uncomplicated appendicitis as an alternative to appendectomy in adults, but large randomized trials in children have been lacking. In this multicenter noninferiority trial, 936 children (age range, 5–16 years) who presented with suspected unperforated appendicitis, with or without fecalith, were randomized to receive either antibiotic therapy (intravenous in hospital, followed by 10 days of oral therapy after discharge) or appendectomy. Inpatient antibiotic choice was left to physicians' preferences. Outpatient antibiotic regimens were either amoxicillin–clavulanate or ciprofloxacin and metronidazole. Treatment failure was defined as a pathological finding of normal appendix…