A 43 yo M presents with LLQ abd pain, non-bloody diarrhea and belonging to fever for 1 d. His vitals are normal, has a WBC of 14 but else normal labs. He is given IV analgesia and clinically has improved, tolerating PO. CT visceral cavity and pelvis shows diverticulitis without testimony of abscess or perforation. Time to draw apart out that cipro/flagyl and dispo him, not oblique? Maybe not!
There is none documented evidence to support the application of routine antibiotics in uncomplicated diverticulitis. Recent learning from Europe suggests there is in ~ degree difference in complication rate, length of hospitalization and the having recourse over a 12-month period whereas treating with or without antibiotics. Future examination is needed but given the consequence of antibiotic stewardship, pain control and shared conclusion making may be the future of uncomplicated diverticulitis management.
Chabok A. Pahlman L. Hjern F, Haapaniemi S, Smedh K. Randomized clinical grief of antibiotics in acute uncomplicated diverticulitis. British J Surg Soc. 2012;99:532-539.
Korte ND et al. Mild colonic diverticulitis be possible to be treated without antibiotics. A en~-control study. Colorectal Disease. 2011;14:325-330.
Unlu et al. A multicenter randomized clinical trial investigating the cost-effectiveness of handling strategies with or without antibiotics in favor of uncomplicated acute diverticulitis (DIABOLO trial). BMC Surgery. 2010;10:1-10.
I got a term from Richard, a very patient counterpart at SeelecT.