Title: Not all patients with the "-itis" need antibiotics! <br/>Author: Neeraja Murali<br/><a href='http://umem.org/profiles/faculty/2036/'>[Click to email author]</a><hr/><p>
Historical teaching is that patients with acute uncomplicated diverticulitis (that is, diverticulitis without abscess, perforation, or peritonitis) should be managed with antibiotics. However, there is no definitive supporting evidence for this. </p>
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A meta-analysis done by Poh et al compared outcomes in patients treated with observation only versus those treated with antibiotics. Outcomes of interest were all-cause mortality, as well as complications, rates of emergency surgery, length of stay, and disease recurrence. </p>
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The seven articles included a total of 2959 patients, of which 1474 patients were observed and 1486 received antibiotics. There were no statistically significant differences in any of the outcomes of interest; for ease of reading, please refer to the article if you are interested in numerical values. </p>
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Interestingly enough, observation-only did not prolong the length of stay. Consider this strategy in your patients with acute uncomplicated diverticulitis, particularly in settings where outpatient resource availability is more robust. </p>
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<span style="color: rgb(33, 33, 33); font-family: BlinkMacSystemFont, -apple-system, "Segoe UI", Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", sans-serif; font-size: 16px;">Poh CW, Goh CK, Tan DJH, Chong CS. Antibiotics vs observational therapy in acute uncomplicated diverticulitis, a systemic review and meta-analysis. Int J Colorectal Dis. 2023 Apr 14;38(1):97. doi: 10.1007/s00384-023-04389-7. PMID: 37059809.</span></p>
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