Optimizing the antibiotic treatment of uncomplicated acute appendicitis - APPAC II

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• The exclusion criteria are: 1) Age under 18 or over 60 years, 2) Pregnancy or lactation, 3) Allergy to contrast media or iodine, 4) Allergy or contraindication to antibiotic therapy, 5) Renal insufficiency or serum creatinine value exceeding the upper reference limit, 6) Type 2 diabetes mellitus and metformine medication, 7) Severe systemic illness (for example malignancy, medical condition requiring immunosuppressant medication), 8) Inability to co-operate and give informed consent, and 9) Complicated acute appendicitis in the CT scan. A radiological diagnosis of complicated acute appendicitis is defined as typical findings of appendicitis with at least one of the following: appendicolith, periappendiceal abscess, perforation, or suspicion of an appendiceal tumor. Contraindications for the use of antibiotics include either allergy to the antibiotic regimen, auxiliary substance of the drug, or interaction with other medications of patient. In the case of quinolones, epilepsy and previously diagnosed tendinitis or tendon rupture related to quinolone treatment are contraindications. With moxifloxacin, additional contraindications are liver failure (also a general contraindication for study enrolment), heart condition (for example prolonged QT-time) and electrolyte imbalance. Other overall contraindications to antibiotic treatment in general including pregnancy or lactation and age under 18 years, do not apply as these patients will not be evaluated for study enrolment based on general exclusion criteria.