Contemporary research suggests that physicians could offer patients with computed tomography (CT)–confirmed uncomplicated acute appendicitis a choice between surgery and antibiotics.^1-5 In the recent Appendicitis Acuta (APPAC) II trial² aiming to optimize antibiotic treatment of uncomplicated acute appendicitis in adults, 70.2% of the patients (207 of 295) randomized to receive oral antibiotic monotherapy and 73.8% of patients (213 of 288) randomized to receive intravenous antibiotics followed by oral antibiotics avoided surgery at 1-year follow-up. To further improve patient selection and subsequently the success rate of nonoperative treatment for uncomplicated acute appendicitis, accurate differential diagnosis between uncomplicated and complicated acute appendicitis ruling out complicated appendicitis is essential. The objective of this study was to assess potential preintervention findings associated with primary nonresponsiveness to antibiotics in the APPAC II trial.

当代研究表明，医生可以为经计算机断层扫描 (CT) 确诊的单纯性急性阑尾炎患者提供手术和抗生素之间的选择。^{1 -5}在最近的急性阑尾炎 (APPAC) II 试验中²旨在优化成人单纯性急性阑尾炎的抗生素治疗，70.2% 的患者（295 名中的 207 名）随机接受口服抗生素单药治疗，73.8% 的患者（288 名中的 213 名）随机接受静脉注射抗生素，随后口服抗生素避免手术1年随访。为了进一步提高患者的选择，进而提高单纯性急性阑尾炎非手术治疗的成功率，准确鉴别单纯性和复杂性急性阑尾炎，排除复杂性阑尾炎至关重要。本研究的目的是评估与 APPAC II 试验中对抗生素原发性无反应相关的潜在干预前发现。