Evidence map›Paper›PMID 25992746›Full record

Trial reportThe New England journal of medicine2015

Trial of short-course antimicrobial therapy for intraabdominal infection.

Robert G Sawyer, Jeffrey A Claridge, Avery B Nathens, Ori D Rotstein, Therese M Duane, Heather L Evans, Charles H Cook, Patrick J O'Neill, John E Mazuski, Reza Askari and 17 more

Erratum issued 5 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 5 registered trials, which are not on this map. Cited by 270 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
270citing papers in PubMed, 12 pooled it
59.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00657566 phase3completednot on this map

SIS Multicenter Study of Duration of Antibiotics for Intraabdominal Infection

TypeinterventionalSponsorUniversity of VirginiaRan2008 to 2014Enrolled518ConditionsPeritonitisArmsduration of antibiotics
NCT03265834 phase2completednot on this mapstarted 2017, after this paper: background citation

The CABI Trial: An Unblinded Parallel Group Randomised Controlled Feasibility Trial of Long Course Antibiotic Therapy (28 Days) Compared to Short Course (≤10 Days) in the Prevention of Complicated Intra-ABdominal Infection Relapses in Adults Treated for Complicated Intra-ABdominal Infection

TypeinterventionalSponsorUniversity of LeedsRan2017 to 2018Enrolled31ConditionsComplicated Intraabdominal InfectionsArms< 10 days of antibiotics, 28 days of antibiotics
NCT05002829 nacompletednot on this mapstarted 2021, after this paper: background citation

Complex And Simple Appendicitis: REstrictive or Liberal Post-operative Antibiotic eXposure (CASA RELAX) Using Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR): A Randomized Controlled Trial at Denver Health

TypeinterventionalSponsorDenver Health and Hospital AuthorityRan2021 to 2025Enrolled657ConditionsAppendicitisArmsRestricted Duration of SOC Antibiotic Use, Liberal Duration of SOC Antibiotic Use
NCT05838248 naterminatednot on this mapstarted 2023, after this paper: background citation

Complex and Simple Appendicitis: REstrictive or Liberal Post-operative Antibiotic eXposure (CASA RELAX) Using Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR)

TypeinterventionalSponsorUniversity of LouisvilleRan2023 to 2025Enrolled23ConditionsAppendicitisArmsantibiotic duration
NCT07563933 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

One Versus Five Days of Antibiotics After Appendectomy for Straightforward Acute Appendicitis: Study Protocol for a Randomized Controlled Trial

TypeinterventionalSponsorMinistry of Health and Population, EgyptRan2026 to 2027Enrolled200ConditionsPost Operative Antibiotic Therapy of Acute AppendicitisArmsa single day (24 hours) post operative
3 · Its place in the literature

Who cites it

270 citing papers in PubMed, 12 syntheses or guidelines pooled it, 718 citations in OpenAlex.

  1. [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025
    Guideline
  2. Guideline
  3. Guideline
  4. ShortWorld journal of gastroenterology · 2023
    Pooled it
  5. Pooled it
  6. Guideline
  7. [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020
    Guideline
  8. Guideline
  9. Perforated and bleeding peptic ulcer: WSES guidelines.World journal of emergency surgery : WJES · 2020
    Guideline
  10. Pooled it
  11. Guideline
  12. Pooled it
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Antibiotic Therapy for Pseudomonas aeruginosa Bloodstream Infections: How Long Is Long Enough?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019
    Trial
  19. Review
  20. Article

210 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors at 20 institutions in 3 countries.

Robert G SawyerFrom the Department of Surgery, University of Virginia Health System, Charlottesville (R.G.S., C.A.G., K.P.); the Department of Surgery, Virginia Commonwealth University, Richmond (T.M.D.); the Department of Surgery, Case Western Reserve University, Cleveland (J.A.C.); the Department of Surgery, University of Toronto, Toronto (A.B.N., O.D.R.); the Department of Surgery, University of Washington, Seattle (H.L.E., E.P.D.); the Department of Surgery, Beth Israel Deaconess Medical Center (C.H.C.), and the Department of Surgery, Brigham and Women's Hospital (R.A.) - both in Boston; the Department of Surgery, Maricopa Integrated Health System, Phoenix, AZ (P.J.O.); the Department of Surgery, Washington University, St. Louis (J.E.M.); the Department of Surgery, VA Pittsburgh Healthcare System, Pittsburgh (M.A. Wilson); the Department of Surgery, University of Michigan, Ann Arbor (L.M.N.); the Department of Surgery, University of Miami Miller School of Medicine, Miami (N.N.); the Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC (P.R.M.); the Department of Surgery, University of South Carolina, Columbia (C.M.W.); University of California, San Diego, San Diego (R.C.), the Department of Surgery, UC Davis Medical Center, Sacramento (C.S.C.), and the Department of Surgery, University of California, San Francisco, San Francisco (M.A. West) - all in California; the Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio (D.L.D.); the Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark (S.F.L.); the Department of Surgery, University of Minnesota Medical School, Minneapolis (K.L.B.); the Department of Surgery, University of Louisville School of Medicine, Louisville, KY (W.G.C.); and the Department of Surgery, Johns Hopkins University School of Medicine, Baltimore (P.A.L.).
Jeffrey A Claridge
Avery B Nathens
Ori D Rotstein
Therese M Duane
Heather L Evans
Charles H Cook
Patrick J O'Neill
John E Mazuski
Reza Askari
Mark A Wilson
Lena M Napolitano
Nicholas Namias
Preston R Miller
E Patchen Dellinger
Christopher M Watson
Raul Coimbra
Daniel L Dent
Stephen F Lowry
Christine S Cocanour
Michaela A West
Kaysie L Banton
William G Cheadle
Pamela A Lipsett
Christopher A Guidry
Kimberley Popovsky
STOP-IT Trial Investigators
University of Virginia Health System · USUniversity of Toronto · CAUniversity of Washington · USBrigham and Women's Hospital · USCase Western Reserve University · USHadassah Medical Center · ILJohns Hopkins University · USThe University of Texas Health Science Center at San Antonio · USUniversity Hospital, Newark · USUniversity of California Davis Medical Center · USUniversity of California San Diego · USUniversity of California, San Francisco · USUniversity of Louisville · USUniversity of Miami · USUniversity of Michigan · USUniversity of Minnesota Medical Center · USUniversity of South Carolina · USValleywise Health · USVA Pittsburgh Healthcare System · USVirginia Commonwealth University · US

Funding

SIS multicenter study of duration of antibiotics for intraabdominal infectionR01GM081510 · NIGMS · UNIVERSITY OF VIRGINIA · PI SAWYER, ROBERT G · 2007 to 2011
$3.3M
Surgical Infectious Diseses and Transplantation Training GrantT32AI078875 · NIAID · UNIVERSITY OF VIRGINIA · PI SAWYER, ROBERT G · 2009 to 2013
$947k
NIAID NIH HHS T32 AI078875NIGMS NIH HHS R01 GM081510NIGMS NIH HHS R01GM081510
6 · The paper itself

Abstract

backgroundThe successful treatment of intraabdominal infection requires a combination of anatomical source control and antibiotics. The appropriate duration of antimicrobial therapy remains unclear.

methodsWe randomly assigned 518 patients with complicated intraabdominal infection and adequate source control to receive antibiotics until 2 days after the resolution of fever, leukocytosis, and ileus, with a maximum of 10 days of therapy (control group), or to receive a fixed course of antibiotics (experimental group) for 4±1 calendar days. The primary outcome was a composite of surgical-site infection, recurrent intraabdominal infection, or death within 30 days after the index source-control procedure, according to treatment group. Secondary outcomes included the duration of therapy and rates of subsequent infections.

resultsSurgical-site infection, recurrent intraabdominal infection, or death occurred in 56 of 257 patients in the experimental group (21.8%), as compared with 58 of 260 patients in the control group (22.3%) (absolute difference, -0.5 percentage point; 95% confidence interval [CI], -7.0 to 8.0; P=0.92). The median duration of antibiotic therapy was 4.0 days (interquartile range, 4.0 to 5.0) in the experimental group, as compared with 8.0 days (interquartile range, 5.0 to 10.0) in the control group (absolute difference, -4.0 days; 95% CI, -4.7 to -3.3; P<0.001). No significant between-group differences were found in the individual rates of the components of the primary outcome or in other secondary outcomes.

conclusionsIn patients with intraabdominal infections who had undergone an adequate source-control procedure, the outcomes after fixed-duration antibiotic therapy (approximately 4 days) were similar to those after a longer course of antibiotics (approximately 8 days) that extended until after the resolution of physiological abnormalities. (Funded by the National Institutes of Health; STOP-IT ClinicalTrials.gov number, NCT00657566.).

Indexed as

AdolescentAdultAgedAged, 80 and overAnti-Bacterial AgentsAppendicitisDrug Administration ScheduleFemaleFeverHumansIntraabdominal InfectionsKaplan-Meier EstimateLeukocytosisMaleMedication AdherenceMiddle AgedAnti-Bacterial Agents

Identifiers

PMID25992746
PMCPMC4469182
OpenAlexW2148077193

What OpenQuestion holds

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LicenceTDM
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.