Complex And Simple Appendicitis: REstrictive or Liberal Post-operative Antibiotic eXposure (CASA RELAX) - Atrium Health

NCT ID: NCT05746520

Last Updated: 2025-11-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

268 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-02

Study Completion Date

2025-07-21

Brief Summary

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To demonstrate the safety, efficacy, and feasibility of short-course post-operative antibiotic treatment for simple and complicated appendicitis

Detailed Description

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This is a single center, randomized controlled trial to determine if decreasing the amount of antibiotics after appendicitis surgery can decrease the risk of adverse effects associated with antibiotics while at the same time ensuring participant safety.

Conditions

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Appendicitis Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Restricted Post-Operative Antibiotics Group

Participants undergoing standard of care (SOC) with simple appendicitis will not receive post-operative antibiotics.

Participants undergoing standard of care (SOC) with complicated (gangrenous or perforated) appendicitis will receive 24 hours of SOC post-operative antibiotics.

Group Type EXPERIMENTAL

Antibiotic

Intervention Type OTHER

Type of antibiotic is per clinical judgement with the duration being the experimental aspect of this study.

Restricted Duration of SOC Antibiotic Use

Use of Standard of Care Antibiotics, type as determined by the clinician, will be restricted to none or 24 hours of post-operatively.

Group Type OTHER

Antibiotic

Intervention Type OTHER

Type of antibiotic is per clinical judgement with the duration being the experimental aspect of this study.

Liberal Post-Operative Antibiotics Group

Participants undergoing standard of care (SOC) with simple appendicitis will receive 24 hours of post-operative antibiotics.

Participants undergoing standard of care (SOC) with complicated (gangrenous or perforated) appendicitis will receive 4 days of SOC post-operative antibiotics.

Group Type ACTIVE_COMPARATOR

Antibiotic

Intervention Type OTHER

Type of antibiotic is per clinical judgement with the duration being the experimental aspect of this study.

Liberal Duration of SOC Antibiotic Use

Use of Standard of Care Antibiotics, type as determined by the clinician, will be permitted for 24 hours or 4 days of post-operatively.

Group Type OTHER

Antibiotic

Intervention Type OTHER

Type of antibiotic is per clinical judgement with the duration being the experimental aspect of this study.

Interventions

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Antibiotic

Type of antibiotic is per clinical judgement with the duration being the experimental aspect of this study.

Intervention Type OTHER

Other Intervention Names

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antibiotics are per standard of care (SOC)

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* Planned appendectomy (laparoscopic or open)
* Willing and able to provide informed consent
* Working telephone number or reliable method to contact patient after hospital discharge

Exclusion Criteria

* Unable to consent
* Pregnant Women
* Prisoners
* immunocompromised as determined by clinical team, or patients actively receiving steroids, chemotherapy, or immunosuppressing medications (for example tacrolimus), or patients with active hematologic malignancy affecting the immune system, leukopenia, or end-stage Acquired immunodeficiency syndrome (AIDS)
* Heart Failure
* Allergy to Bupivacaine
* Unlikely to comply with treatment or follow-up
* Inpatient consultation for appendicitis
* Clinically suspected sepsis based on Sepsis-3 definition
* Current use of antibiotics for other indications
* Type 1 Diabetes or uncontrolled hyperglycemia
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rafael Torres Fajardo, MD

Role: PRINCIPAL_INVESTIGATOR

Wake Forest University Health Sciences

Locations

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Wake Forest University Health Sciences

Winston-Salem, North Carolina, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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IRB00086118

Identifier Type: -

Identifier Source: org_study_id

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