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

Launched by UNIVERSITY OF LOUISVILLE · Apr 20, 2023

Keywords

ClinConnect Summary

The CASA RELAX clinical trial is looking at how long patients should take antibiotics after having their appendix removed (a procedure called an appendectomy). The study focuses on two types of appendicitis: simple and complex. For simple appendicitis, patients will either receive antibiotics during surgery or for just 24 hours afterward. For complex appendicitis, the options are 24 hours or four days of antibiotics. The goal is to find out if shorter courses of antibiotics are just as safe and effective as longer ones.

To participate in this study, you must be at least 18 years old and scheduled for an appendectomy. You also need to be able to give your consent and have a reliable way to be contacted after you leave the hospital. However, some people may not be eligible, such as those who are pregnant, have certain health conditions that weaken their immune system, or are currently taking antibiotics for other reasons. If you join the trial, you’ll be randomly assigned to one of the antibiotic duration groups and will help researchers learn more about the best ways to use antibiotics after surgery.

Gender

ALL

Eligibility criteria

• 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 AIDS
• • Heart failure
• • Allergy to bupivacaine
• • Unlikely to comply with treatment or follow-up
• • Inpatient consultation for appendicitis
• • Clinically suspected of sepsis based on Sepsis-3 definition
• • Current use of antibiotics for other indications
• • Type 1 Diabetes or uncontrolled hyperglycemia
• • Surgeon preference
• • Patient preference
• • Research team unavailable