This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. BJS 2012; 99: 532-539.
Published: 30th January 2012
Authors: A. Chabok, L. Påhlman, F. Hjern, S. Haapaniemi, K. Smedh
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.
Method
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 (