Short versus standard course postoperative antibiotic treatment for complex acute appendicitis

INTERVENTION: After appendectomy for complex acute appendicitis, patients will be randomized to either A) discontinuing antibiotic treatment after 48 hours of intravenous antibiotics (intervention group), or B) continuing antibiotic treatment for three more days (control group). Antibiotics given intravenously are cefuroxime and metronidazole. In children the doses will be adjusted according to their weight. CONDITION: Acute appendicitis ; ; PRIMARY OUTCOME: The primary endpoint is a composite endpoint postoperative infectious complications related to appendectomy, including intra‐abdominal abscess and surgical site infection, and mortality within 90 days after appendectomy. SECONDARY OUTCOME: Secondary objectives are cost‐effectiveness, intra‐abdominal abscess, superficial and/or deep surgical site infections, mortality, duration of postoperative antibiotic treatment, re‐start of antibiotics, hospital stay in hours from the operation, time to reach discharge criteria in hours from the operation, emergency room visits, readmission rate and adverse events on antibiotics (all within 90 days after appendectomy). INCLUSION CRITERIA: ‐ age minimum 8 years old (no upper limit) ‐ patients with suspected acute appendicitis, awaiting appendectomy ‐ written informed consent ‐ intraoperative diagnosis of a complex appendicitis