CODA Trial Results & Publications

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."

Pre-Results 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)