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No antibiotics in acute uncomplicated diverticulitis: does it work?
Daniel Isacson1, Kalle Andreasson, Maziar Nikberg
1Department of Surgery, Colorectal Unit, Västmanland Hospital Västerås and Centre for Clinical Research Uppsala University, Västmanland Hospital Västerås , Västerås , Sweden.
Scandinavian Journal of Gastroenterology
|November 6, 2014
Summary
The no antibiotic policy for acute uncomplicated diverticulitis (AUD) is safe and effective in clinical practice. This study confirms low complication and recurrence rates, showing no need for antibiotics in AUD cases.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Clinical Practice Guidelines
Background:
- Previous studies suggest no benefit from antibiotics in acute uncomplicated diverticulitis (AUD).
- This study aimed to review the outcomes of a no antibiotic policy for AUD.
Purpose of the Study:
- To evaluate the safety and applicability of a no antibiotic policy for AUD.
- To assess the impact of this policy on complication and recurrence rates.
Main Methods:
- Retrospective population-based cohort study of patients diagnosed with colonic diverticulitis in 2011.
- Inclusion of all medical records for computer tomography-verified diverticulitis cases.
- Primary outcomes: treatment type, complications, and recurrence.
Main Results:
- 195 patients with primary AUD were identified; 91.3% received no antibiotics.
- Low rates of readmission (3.4%) and abscess (1.0%) were observed in the no-antibiotic AUD group.
- Recurrence within 1 year was observed in 12.8% of the AUD group.
Conclusions:
- The no antibiotic policy for AUD is safe and applicable in clinical practice.
- Low complication and recurrence rates in AUD are confirmed.
- Antibiotic treatment is not necessary for acute uncomplicated diverticulitis.
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