The APPAC trial compared antibiotic treatment (ertapenem IV then levofloxacin + metronidazole orally for 7 days) versus appendicectomy for uncomplicated acute appendicitis. At 5 years, the recurrence rate in the antibiotic group was approximately:

• A 10%
• B 25%
• C 55%
• D 39% ✓

Explanation

The APPAC 5-year follow-up showed that approximately 39% of patients initially treated with antibiotics had eventually undergone appendicectomy, with most recurrences in the first year. However, 61% remained recurrence-free at 5 years without surgery. Crucially, no antibiotic-treated patient suffered perforation during delayed appendicectomy. This evidence supports offering antibiotics as a valid non-operative option for select uncomplicated cases, with patient counselling about recurrence risk.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.