PMID- 25369865
OWN - NLM
STAT- MEDLINE
DCOM- 20150720
LR  - 20191210
IS  - 1502-7708 (Electronic)
IS  - 0036-5521 (Linking)
VI  - 49
IP  - 12
DP  - 2014 Dec
TI  - No antibiotics in acute uncomplicated diverticulitis: does it work?
PG  - 1441-6
LID - 10.3109/00365521.2014.968861 [doi]
AB  - BACKGROUND: The first randomized multicenter study evaluating the need for 
      antibiotic treatment in patients with acute uncomplicated diverticulitis (AUD) 
      could not demonstrate any benefit gained from antibiotic use. The aim of this 
      study was to review the application of the no antibiotic policy and its 
      consequences in regard to complications and recurrence. METHODS: This 
      retrospective population-based cohort study included all patients diagnosed with 
      all types of colonic diverticulitis during the year 2011 at Vastmanland Hospital 
      Vasteras, Sweden. All medical records were carefully reviewed. Primary outcomes 
      were the types of treatment adopted for diverticulitis, complications and 
      recurrence. RESULTS: In total, 246 patients with computer tomography-verified 
      diverticulitis were identified, 195 with primary AUD and 51 with acute 
      complicated diverticulitis. Age, sex, and temperature at admission were similar 
      between the groups but there was a significant difference in white blood cell 
      count, C-reactive protein, and length of hospital stay. In the AUD group, 178 
      (91.3%) patients were not treated with antibiotics. In this group, there were six 
      (3.4%) readmissions but only two developed an abscess. Of the remaining 17 
      patients (8.7%) who were treated with antibiotics in the AUD group, one developed 
      an abscess. Twenty-five (12.8%) patients in the AUD group presented with a 
      recurrence within 1 year. CONCLUSION: The no-antibiotic policy for AUD is safe 
      and applicable in clinical practice. The previous results of a low complication 
      and recurrence rate in AUD are confirmed. There is no need for antibiotic 
      treatment for AUD. What does this paper add to the literature? Despite published 
      papers with excellent results, there are still doubts about patient safety 
      against the policy to not use antibiotics in acute uncomplicated diverticulitis. 
      This is the first paper, in actual clinical practice, to confirm that the no 
      antibiotic policy for acute uncomplicated diverticulitis is applicable and safe.
FAU - Isacson, Daniel
AU  - Isacson D
AD  - Department of Surgery, Colorectal Unit, Vastmanland Hospital Vasteras and Centre 
      for Clinical Research Uppsala University, Vastmanland Hospital Vasteras , 
      Vasteras , Sweden.
FAU - Andreasson, Kalle
AU  - Andreasson K
FAU - Nikberg, Maziar
AU  - Nikberg M
FAU - Smedh, Kenneth
AU  - Smedh K
FAU - Chabok, Abbas
AU  - Chabok A
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141105
PL  - England
TA  - Scand J Gastroenterol
JT  - Scandinavian journal of gastroenterology
JID - 0060105
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Combined Modality Therapy
MH  - Diverticulitis, Colonic/complications/drug therapy/*therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - antibiotics
OT  - colonic diverticulitis
OT  - complications
EDAT- 2014/11/06 06:00
MHDA- 2015/07/21 06:00
CRDT- 2014/11/06 06:00
PHST- 2014/11/06 06:00 [entrez]
PHST- 2014/11/06 06:00 [pubmed]
PHST- 2015/07/21 06:00 [medline]
AID - 10.3109/00365521.2014.968861 [doi]
PST - ppublish
SO  - Scand J Gastroenterol. 2014 Dec;49(12):1441-6. doi: 10.3109/00365521.2014.968861. 
      Epub 2014 Nov 5.