Breaking the Antibiotic Habit: Shorter Treatments for Complicated Appendicitis
Bibliographic record
Abstract
Background: Patients with acute complicated appendicitis, including gangrenous or perforated appendicitis and/or the presence of an abscess formation, usually require surgery followed by antibiotics. The optimal duration of antibiotic therapy for those infections is debatable; prolonged courses are practiced at other institutions. Objectives: We undertook this systematic review and comparison to assess the efficacy of various durations of postoperative antibiotic therapy on patients healing from complicated acute appendicitis. The endpoint was defined as overall infections, length-of-sickness hospitalization (LOS), and readmissions in randomizing-controlled scan trials that tested different periods for which a patient received antibiotics after surgery. Methods: A comprehensive search included MEDLINE, Cochrane Library, Web of Science, Embase, PubMed, and Google Scholar. We included studies with randomized controlled trials, cohort studies, and cohort and observational studies that compared various durations of postoperative antibiotics among adults or children suffering from complicated appendicitis. Results: Data was extracted and analyzed for infection rates, LOS, and readmission outcomes. Results: We included 13 studies with 4,675 participants in the meta-analysis. The meta-analysis found that short-term antibiotic therapy (≤5 days) is as effective as longer courses (> five days) in the prevention of postoperative infections. Patients in both the short- and long-term groups experienced similar rates of surgical site infections, intra-abdominal abscesses, and new-onset sepsis. Short-term therapy was also linked to a shorter LOS and comparable readmission rates.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.007 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".