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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04803422
Other study ID # P-2021-27
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date May 1, 2021
Est. completion date May 31, 2024

Study information

Verified date May 2023
Source Zealand University Hospital
Contact Ahmed Abdirahman Mohamud, MD
Phone +45 23485194
Email ahmm@regionsjaelland.dk
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The PIPA trial is a prospective, multicentre, cluster randomized cluster crossover non-inferiority study. We aim to test whether a three-day postoperative course of per oral antibiotics is non-inferior to a three-day postoperative course of intravenous antibiotics as standard care after laparoscopic surgery for complicated appendicitis in regards to the risk of postoperative intraabdominal abscess formation within 30-days


Description:

Complicated appendicitis increases the risk of postoperative intra-abdominal abscess. Treatment of complicated appendicitis are usually with a postoperative course of intravenous antibiotics. There is need for a study confirming the results of retrospective studies showing that a postoperative course of oral antibiotics is not inferior to intravenous antibiotics after laparoscopic surgery for complicated appendicitis. The PIPA trial will be a prospective, multicenter, cluster randomized cluster crossover non-inferiority study designed to test whether a three-day postoperative course of per oral antibiotics is non-inferior to a three-day postoperative course of intravenous antibiotics as standard care after laparoscopic surgery for complicated appendicitis in regards to the risk of postoperative intraabdominal abscess formation within 30-days. Participating hospitals will be randomized to either a 6-month period with a per oral antibiotic regime followed by a 6-month period with an intravenous antibiotic regime, or 6-month period with an intravenous antibiotic regime followed by a 6-month period with a per oral antibiotic regime for the postoperative treatment after laparoscopic surgery for complicated appendicitis. Primary outcome will be the incidence of intra-abdominal abscess by the postoperative day 30. The study duration has been extended by three months in both arms, totaling six months, due to insufficient patient recruitment. By addressing this challenge, the research team seeks to achieve a more representative sample size to ensure robust and reliable research outcomes.


Recruitment information / eligibility

Status Recruiting
Enrollment 2631
Est. completion date May 31, 2024
Est. primary completion date May 31, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - On cluster level, hospitals with emergency surgical admissions performing laparoscopic appendectomies are eligible for inclusion. - On an individual level, participants are eligible for inclusion if they undergo a laparoscopic appendectomy for appendicitis (both uncomplicated and complicated), are = 18 years of age, and provide a signed written consent form. Exclusion Criteria: - Exclusion criteria are specifically related to the therapy and individual participants will be excluded if they undergo any other procedures than laparoscopic appendectomy during index surgery.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Antibiotic
The study aims to test whether oral antibiotics is non-inferior compared to intravenous antibiotics.

Locations

Country Name City State
Denmark Department of Surgery, Slagelse Hospital Slagelse
Denmark Slagelse Hospital, Department of Surgery Slagelse

Sponsors (1)

Lead Sponsor Collaborator
Zealand University Hospital

Country where clinical trial is conducted

Denmark, 

Outcome

Type Measure Description Time frame Safety issue
Primary Intra-abdominal abscess Primary outcome is defined as an imaging verified intraabdominal mass treated with drainage or antibiotics, or a surgically verified intra-abdominal abscess Assessed at postoperative day 30
Secondary postoperative stay postoperative length of stay measured in hours The event is assessed at postoperative day 30. The event is determnied beginning from the time the surgery ends till the time the patient is discharged from the hospital.
Secondary Complications according to Clavien-Dindo Classifcation complications according to the Clavien-Dindo classification at postoperative day 30, that require in- or outpatient treatment, complications grade =3a according to Clavien-Dindo Classification at postoperative day 30 Assessed at postoperative day 30
Secondary Costs In- and outpatient costs and overall costs of both in-and- outpatient Assessed at postoperative day 30. Data for both in- and outpatient costs will be extracted from the Danish Health Authority
Secondary Wound infection Postoperative wound infection that require in-and - outpatient treatment. A wound infection is defined as a clinically suspected wound infection which has been treated with an opening of the wound or where antibiotics has been administered for this indication Assessed postoperative day 30
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