Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis13
Top Cited Papers
- 30 January 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 99 (4), 532-539
- https://doi.org/10.1002/bjs.8688
Abstract
Background: The standard of care for acute uncomplicated diverticulitis today is antibiotic treatment, although there are no controlled studies supporting this management. The aim was to investigate the need for antibiotic treatment in acute uncomplicated diverticulitis, with the endpoint of recovery without complications after 12 months of follow‐up. Methods: This multicentre randomized trial involving ten surgical departments in Sweden and one in Iceland recruited 623 patients with computed tomography‐verified acute uncomplicated left‐sided diverticulitis. Patients were randomized to treatment with (314 patients) or without (309 patients) antibiotics. Results: Age, sex, body mass index, co‐morbidities, body temperature, white blood cell count and C‐reactive protein level on admission were similar in the two groups. Complications such as perforation or abscess formation were found in six patients (1·9 per cent) who received no antibiotics and in three (1·0 per cent) who were treated with antibiotics (P = 0·302). The median hospital stay was 3 days in both groups. Recurrent diverticulitis necessitating readmission to hospital at the 1‐year follow‐up was similar in the two groups (16 per cent, P = 0·881). Conclusion: Antibiotic treatment for acute uncomplicated diverticulitis neither accelerates recovery nor prevents complications or recurrence. It should be reserved for the treatment of complicated diverticulitis. Registration number: NCT01008488 ( http://www.clinicaltrials.gov). Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.Keywords
This publication has 15 references indexed in Scilit:
- Prevalence of fecal carriage of antibiotic-resistant bacteria in patients with acute surgical abdominal infectionsScandinavian Journal of Gastroenterology, 2010
- Randomized controlled trial of oral vs intravenous therapy for the clinically diagnosed acute uncomplicated diverticulitisColorectal Disease, 2009
- Diverticulitis in the United States: 1998–2005Annals of Surgery, 2009
- The Clinical Picture of Uncomplicated Versus Complicated Diverticulitis of the ColonDigestive Diseases and Sciences, 2008
- A Hypothesis: Is Diverticulitis a Type of Inflammatory Bowel Disease?Journal of Clinical Gastroenterology, 2006
- Complicated DiverticulitisAnnals of Surgery, 2005
- The out‐patient management of patients with acute mild‐to‐moderate colonic diverticulitisAlimentary Pharmacology & Therapeutics, 2005
- 10.1002/bjs.1800840427Crossref Listing of Deleted Dois, 2000
- Computed tomography in acute left colonic diverticulitisBritish Journal of Surgery, 1997
- The outcome in 455 patients admitted for treatment of diverticular disease of the colonBritish Journal of Surgery, 1970