CODA Results Publications

A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis (October 2020)
Publication (New England Journal of Medicine)
Plain Language Summary (PDF)
Infographic: Deciding Between Antibiotics and Surgery for Appendicitis: Findings from the CODA Study (download a PDF version here)
Short Video Summary (New England Journal of Medicine, requires set-up of free account to view)

Conclusions: "For the treatment of appendicitis, antibiotics were noninferior to appendectomy on the basis of results of a standard health-status measure. In the antibiotics group, nearly 3 in 10 participants had undergone appendectomy by 90 days. Participants with an appendicolith were at a higher risk for appendectomy and for complications than those without an appendicolith."
 

Antibiotics versus Appendectomy for Acute Appendicitis - Longer-term Outcomes (October 2021)
Publication (New England Journal of Medicine)
Townhall meeting for participants (YouTube)

Conclusions: "In the antibiotics groups, the percentage of patients who underwent subsequent appendectomy was 40% at 1 year and 46% at 2 years; the percentages were 49%  at 3 and 4 years, according to limited longer-term follow-up. At 30 days after randomization, the risk of appendectomy was 27% through 1 year. Appendectomy was more common among patients who had an appendicolith, but this greater risk was attenuated with time."

Other CODA Publications

Comparison of Outcomes of antibiotic Drugs and Appendectomy (CODA) trial: a protocol for the pragmatic randomised study of appendicitis treatment (November 2017)
Publication (BMJ Open)

Methods for Incorporating Stakeholder Engagement into Clinical Trial Design (May 2017)
Publication (eGEMs)

Evidence for an Antibiotics-First Strategy for Uncomplicated Appendicitis in Adults: A Systematic Review and Gap Analysis (December 2016)
Publication (Journal of the American College of Surgeons)

Engaging Stakeholders in Surgical Research: The Design of a Pragmatic Clinical Trial to Study Management of Acute Appendicitis (June 2016)
Publication (JAMA)