Antibiotics provide a reliable option for adults with uncomplicated acute appendicitis, showing long-term effectiveness.

• After 10 years, 37.8% of patients treated with antibiotics experienced appendicitis recurrence, and 44.3% underwent appendectomy.
• Complication rates were significantly lower with antibiotics (8.5%) versus surgery (27.4%).
• Quality of life outcomes were similar, indicating antibiotics do not compromise patient wellbeing.

Surgeons should consider antibiotics as a first-line treatment, especially in carefully selected patients.