Related Experiment Video
Updated: Aug 3, 2025
Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
Published on: March 15, 2024
Treatment for acute uncomplicated diverticulitis without antibiotherapy: systematic review and meta-analysis of
Alba Correa Bonito1, Carlos Cerdán Santacruz1, Marcello Di Martino2
1Colorectal Surgery Unit, General and Digestive Surgery Service.
Background:
Use of antibiotics in selected cases of acute uncomplicated diverticulitis (AUD) has recently been questioned.
Objective:
The aim of this study is to examine the safety and efficacy of treatment regimens without antibiotics compared with that of traditional treatments with antibiotics in selected patients with AUD.
Data Sources:
PubMed, Medline, Embase, Web of Science, and the Cochrane Library.
Methods:
A systematic review was performed according to PRISMA and AMSTAR guidelines by searching through Medline, Embase, Web of Science, and the Cochrane Library for randomized clinical trials (RCTs) published before December 2022. The outcomes assessed were the rates of readmission, change in strategy, emergency surgery, worsening, and persistent diverticulitis.
Study Selection:
RCTs on treating AUD without antibiotics published in English before December 2022 were included.
Intervention:
Treatments without antibiotics were compared with treatments with antibiotics.
Main Outcome Measures:
The outcomes assessed were the rates of readmission, change in strategy, emergency surgery, worsening, and persistent diverticulitis.
Results:
The search yielded 1163 studies. Four RCTs with 1809 patients were included in the review. Among these patients, 50.1% were treated conservatively without antibiotics. The meta-analysis showed no significant differences between nonantibiotic and antibiotic treatment groups with respect to rates of readmission [odds ratio (OR)=1.39; 95% CI: 0.93-2.06; P =0.11; I2 =0%], change in strategy (OR=1.03; 95% CI: 0.52-2,02; P =0.94; I2 =44%), emergency surgery (OR=0.43; 95% CI: 0.12-1.53; P =0.19; I2 =0%), worsening (OR=0.91; 95% CI: 0.48-1.73; P =0.78; I2 =0%), and persistent diverticulitis (OR=1.54; 95% CI: 0.63-3.26; P =0.26; I2 =0%).
Limitations:
Heterogeneity and a limited number of RCTs.
Conclusions:
Treatment for AUD without antibiotic therapy is safe and effective in selected patients. Further RTCs should confirm the present findings.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...