APPENDECTOMY VERSUS ANTIBIOTIC THERAPY IN THE MANAGEMENT OF UNCOMPLICATED ACUTE APPENDICITIS IN ADULTS: LITERATURE REVIEW

Abstract

This article aimed to analyze recent evidence on appendectomy and antibiotic therapy for uncomplicated acute appendicitis in adults. A structured literature review was conducted in PubMed/MEDLINE, SciELO, and LILACS/BVS, covering publications in Portuguese, English, and Spanish from January 2021 to July 4, 2026, plus three essential historical references. After deduplication, 762 records were screened; 27 underwent detailed eligibility assessment, and 25 contemporary references were included, totaling 28 references in the narrative synthesis. Antibiotic therapy may prevent short-term appendectomy in selected patients, but it carries risks of early failure, recurrence, and delayed surgery, especially in the presence of an appendicolith. Appendectomy remains the definitive and predictable treatment. Nonoperative management is acceptable for stable adults with imaging-confirmed uncomplicated disease, no signs of complication, and access to follow-up; therefore, the decision should be individualized and shared.