Most patients admitted for acute colonic diverticulitis.
Managed conservatively and receive antibiotics, although it is uncertain whether all patients with acute colonic diverticulitis benefit from this treatment.
Dr Fredrik Hjern and team from Sweden evaluated the influence of antibiotic treatment on outcome in the conservative management of mild acute colonic diverticulitis.
The team carried out a retrospective audit of 311 patients hospitalized for acute colonic diverticulitis.
All patients were initially treated conservatively with observation and restriction of oral intake.
|29% treated with antibiotics had further events vs 28% without|
|Scandanavian Journal of Gastroenterology|
The investigative team compared 118 patients receiving antibiotics with 193 patients treated with observation and restriction of oral intake only.
The investigators found that mean follow-up time was 30 months.
The team found inflammation in patients treated with antibiotics was more pronounced.
Fever was more common and computed tomography grading of inflammation was classified as severe in a higher proportion vs patients treated without antibiotics.
When initially treated with antibiotics, 3% of patients failed to respond to treatment and had to undergo surgery.
The investigators observed failures in 4% of patients initially treated without antibiotics, and antibiotics were then added.
During follow-up time, 29% of patients treated with antibiotics had further events compared with 28% among those treated without antibiotics.
The team noted that the risk of a further event was not influenced by antibiotic treatment.
Dr Hjern's team concluded, “The results indicate that antibiotics are not mandatory in mild acute colonic diverticulitis.”
“Treatment without antibiotics appears to be safe and seems not to change the rate of further events.”
“These results warrant further randomized prospective studies.”