What problem does this research address?

Acute appendicitis (AA) is the commonest surgical emergency worldwide. In the U.K., keyhole surgery to remove the appendix is performed in almost all cases, with a smaller number of patients treated using antibiotics alone. This is despite evidence stating that antibiotics alone are effective enough for many patients, avoiding the need for surgery. During the COVID-19 pandemic, it was recommended by leading surgical associations to avoid surgery and to consider antibiotics alone as the first choice in AA. When surgery was subsequently re-started, surgeons returned to performing surgery as the main treatment, despite up-to-date evidence reported during the pandemic that using just antibiotics was effective and safe.

How will this study work?

Using interviews and surveys the research group will investigate patients’ and surgeons’ attitudes and opinions regarding avoiding surgery and just using antibiotics in AA. They will explore reasons which would encourage surgeons, or stop them, from avoiding surgery and attempt to understand why patients would potentially prefer surgery over antibiotics alone. They also plan to perform a cost-effectiveness analysis of antibiotic options to see which provides best value for money for the NHS and patients.

What is the aim of this study?

The team aim to produce and implement antibiotics guidelines for the treatment of AA that centre shared-decision making with patients and their healthcare professionals.

The research team

The study team is based across the UK, and includes surgeons, health economists and surgical trainees. The lead in this study is Professor Susan Moug, a Consultant Surgeon and Honorary Professor at the University of Glasgow.