Bloodstream infections before appendectomy are rare and rarely impact outcomes.

• Among 8,241 appendicitis patients, only 3.7% had positive blood cultures.
• Most infections were expected organisms, primarily Bacteroides and E. coli.

Restricting blood cultures to unstable patients can reduce unnecessary tests and antibiotic use.

• 33.3% of culture-positive patients received no antibiotics post-surgery, highlighting effective surgical management.