Postoperative antibiotics after appendectomy for acute appendicitis, even in patients with intra-abdominal fluid, do not reduce infection rates.

• In a study of 1,539 patients, only 18.1% received postoperative antibiotics, with no significant difference in infection rates regardless of intra-abdominal fluid presence.
• Key risk factors for infection included an ASA score > 2 (HR=5.129), symptom duration > 2 days (HR=2.290), and the presence of an appendicolith (HR=2.204).

Consider focusing on patient-specific risk factors rather than routine antibiotic use, as excessive antibiotics may contribute to resistance.