Publications by authors named "J Haijanen"
Background: Randomised controlled trials (RCTs) have found antibiotics to be a feasible and safe alternative to appendicectomy in adults with imaging-confirmed acute appendicitis. However, patient inclusion criteria and outcome definitions vary greatly between RCTs. We aimed to compare antibiotics with appendicectomy for the treatment of acute appendicitis using individual patient data and uniform outcome definitions.
View Article and Find Full Text PDFBackground: Antibiotic therapy is currently considered a safe and effective treatment alternative for computed tomography (CT)-confirmed uncomplicated acute appendicitis with recent studies reporting good results on both oral antibiotics only and outpatient management. Furthermore, there are promising pilot results on uncomplicated acute appendicitis management with symptomatic treatment (placebo). This trial aims to assess whether both antibiotics and hospitalization can be safely omitted from the treatment of uncomplicated acute appendicitis.
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- Antibiotics can effectively treat uncomplicated acute appendicitis without an appendicolith, but this study focuses on how the presence and characteristics of an appendicolith (a small calculus in the appendix) relate to the severity of appendicitis.
- In a review of over 3,000 patients with suspected appendicitis, it was found that those with an appendicolith had a significantly higher rate of complications (47.1% vs. 21.5%) compared to those without.
- Key findings indicated that certain features of the appendicolith, such as its size, location, and associated appendiceal wall changes, are linked to an increased risk of serious complications in appendicitis patients.
Importance: Current short-term evidence has shown that uncomplicated acute appendicitis can be treated successfully with oral antibiotics alone, but longer-term results are lacking.
Objective: To assess the treatment effectiveness of oral antibiotic monotherapy compared with combined intravenous (IV) and oral antibiotics in computed tomography-confirmed uncomplicated acute appendicitis at a longer-term follow-up.
Design, Setting, And Participants: This secondary analysis of a predefined year 3 follow-up of the Appendicitis Acuta II (APPAC II) noninferiority, multicenter randomized clinical trial compared oral moxifloxacin with combined IV ertapenem plus oral levofloxacin and metronidazole for the treatment of uncomplicated acute appendicitis.