Analysis of Outcomes Associated With Outpatient Management of Nonoperatively Treated Patients With Appendicitis

Key Points Question Is outpatient management with hospital discharge within 24 hours safe among adults receiving antibiotic treatment for acute appendicitis? Findings In this cohort study, which is a secondary analysis of the Comparison of Outcomes of Antibiotic Drugs and Appendectomy trial, that included 726 participants randomized to receive antibiotics, 46% who were judged to meet stability criteria and were discharged within 24 hours had less than 1 serious adverse event per 100 participants through 7 days. Along with subsequent appendectomies, serious adverse events occurred no more frequently in these patients than among hospitalized patients. Meaning These findings support that outpatient antibiotic management is safe for selected adults with acute appendicitis and should be included in shared decision-making discussions of patient preferences for outcomes associated with nonoperative and operative care.