Appendicitis: surgery or antibiotics?

The short answer

Appendectomy is the standard treatment. For some adults with mild, uncomplicated appendicitis, antibiotics alone may be an option, but about 4 in 10 of them later need surgery.

	Appendectomy	Antibiotics alone
What it is	The appendix is removed, by keyhole or open surgery. Operation 45–90 minutes.	Treatment with antibiotics without removing the appendix.
Who it suits	Everyone with appendicitis. It is needed for complicated appendicitis (burst appendix, abscess, peritonitis).	Some adults with mild, uncomplicated appendicitis. Your surgeon decides whether it is safe for you.
The chance of needing surgery	It is the operation.	About 4 in 10 later need an appendectomy.
Recovery	Hospital stay 1–2 days (longer if the appendix had burst); sick leave 7–14 days.	Not covered in our guide.
Main risks	Wound infection 1–3%, bleeding under 1%, abscess inside the abdomen 1–2%, a temporary slowing of the bowel 1–2%.	Without surgery, the appendix can burst, causing severe infection (peritonitis, abscess) or life-threatening sepsis.

Appendectomy

What it is: The appendix is removed, by keyhole or open surgery. Operation 45–90 minutes.
Who it suits: Everyone with appendicitis. It is needed for complicated appendicitis (burst appendix, abscess, peritonitis).
The chance of needing surgery: It is the operation.
Recovery: Hospital stay 1–2 days (longer if the appendix had burst); sick leave 7–14 days.
Main risks: Wound infection 1–3%, bleeding under 1%, abscess inside the abdomen 1–2%, a temporary slowing of the bowel 1–2%.

Antibiotics alone

What it is: Treatment with antibiotics without removing the appendix.
Who it suits: Some adults with mild, uncomplicated appendicitis. Your surgeon decides whether it is safe for you.
The chance of needing surgery: About 4 in 10 later need an appendectomy.
Recovery: Not covered in our guide.
Main risks: Without surgery, the appendix can burst, causing severe infection (peritonitis, abscess) or life-threatening sepsis.

How the choice is made

This is a decision for you and your surgeon, usually made quickly. Do not eat or drink once appendicitis is suspected; the team will tell you what is planned.

Read the full guide: appendectomy

This page gives general information and does not replace the advice of your treating team. Figures are approximate.