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Acute uncomplicated diverticulitis managed without antibiotics - difficult to introduce a new treatment protocol but

Najia Azhar1, Hanna Kulstad2, Birger Pålsson2

  • 1a Colorectal Unit, Department of Surgery , Skåne University Hospital Malmö , Malmö, Sweden.

Scandinavian Journal of Gastroenterology
|January 17, 2019
PubMed
Abstract

Insights

This study found that treating acute uncomplicated diverticulitis (AUD) without antibiotics is safe, with no increase in complications. However, implementing new treatment protocols for AUD can be challenging.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Routine antibiotic use for acute uncomplicated diverticulitis (AUD) is often ineffective.
  • A new antibiotic-free protocol was introduced to manage AUD.
  • Evaluating adherence and complication rates in AUD treatment is crucial.

Purpose of the Study:

  • To assess adherence to a new antibiotic-free protocol for AUD.
  • To investigate complication incidence in AUD patients treated with and without antibiotics.
  • To compare clinical outcomes between antibiotic and non-antibiotic treatment groups for AUD.

Main Methods:

  • Retrospective study of 50 in-patients diagnosed with AUD.
  • Comparison of patients treated with antibiotics versus an antibiotic-free protocol.
  • One-year follow-up for complications in all AUD patients.

Main Results:

  • 60% of patients received antibiotic-free treatment under the new protocol.
  • Non-antibiotic AUD treatment was associated with a shorter hospital stay (2 vs. 3 days).
  • No significant difference in complication rates was observed between groups, though antibiotic group had higher CRP.

Conclusions:

  • Protocol compliance for antibiotic-free AUD treatment was lower than anticipated.
  • Complications are infrequent in AUD managed without antibiotics.
  • Selection bias towards sicker patients for antibiotic treatment complicates result interpretation.
Keywords:
GI-infectionscolonic disorders

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