Which antibiotic for diverticulitis treatment

Br J Surg. Risk factors for diverticulitis include use of nonsteroidal anti-inflammatory drugs, increasing age, obesity, and a sedentary lifestyle. Patients who present with symptoms consistent with recurrent diverticulitis warrant a complete evaluation. Studies have shown recurrence rates of diverticulitis from 9 to 36 percent. In a large retrospective study involving 3, patients treated for diverticulitis with a mean follow-up of nine years, 9 percent had one recurrence and 3 percent had more than one recurrence after initial nonoperative management.

A retrospective study analyzing consecutive patients with diverticulitis found the five-year recurrence rate was 36 percent, with 3. Interventions to prevent recurrences of diverticulitis include increased intake of dietary fiber, exercise, and, in persons with a body mass index of 30 kg per m 2 or higher, weight loss.

Data Sources: A PubMed search was completed in Clinical Queries using the key terms diverticulitis, diverticulosis, diverticular disease, pathogenesis, diagnosis, and treatment. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. Search date: April 15, Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Reprints are not available from the authors. Acute diverticulitis. N Engl J Med.

Diagnosis and management of diverticular disease of the colon in adults. Am J Gastroenterol. The burden of selected digestive diseases in the United States. Diverticulitis in the United States: — changing patterns of disease and treatment. Ann Surg. Cyclical increase in diverticulitis during the summer months.

Arch Surg. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. The genetic influence on diverticular disease — a twin study. Aliment Pharmacol Ther. Use of aspirin or nonsteroidal anti-inflammatory drugs increases risk for diverticulitis and diverticular bleeding.

A clinical decision rule to establish the diagnosis of acute diverticulitis at the emergency department. Acute left colonic diverticulitis: a prospective analysis of consecutive cases. Rebound tenderness test.

Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol. Diagnostic imaging for diverticulitis. J Clin Gastroenterol.

Prospective evaluation of the value of magnetic resonance imaging in suspected acute sigmoid diverticulitis. Diagnostic value of inflammation markers in predicting perforation in acute sigmoid diverticulitis.

World J Surg. Frequency, sensitivity, and specificity of individual signs of diverticulitis on thin-section helical CT with colonic contrast material: experience with cases. Is colonoscopy still mandatory after a CT diagnosis of left-sided diverticulitis: can colorectal cancer be confidently excluded? Routine colonoscopy following acute uncomplicated diverticulitis. Outpatient treatment of acute diverticulitis: rates and predictors of failure.

Prospective randomized clinical trial assessing the efficacy of a short course of intravenously administered amoxicillin plus clavulanic acid followed by oral antibiotic in patients with uncomplicated acute diverticulitis. Int J Colorectal Dis. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America [published correction appears in Clin Infect Dis.

Clin Infect Dis. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Antibiotics for uncomplicated diverticulitis. Cochrane Database Syst Rev. Randomized controlled trial of oral vs intravenous therapy for the clinically diagnosed acute uncomplicated diverticulitis. Colorectal Dis. Hospitalization for acute diverticulitis does not mandate routine elective colectomy.

Anti-inflammatory drugs, analgesics and the risk of perforated colonic diverticular disease. Is the decline in the surgical treatment for diverticulitis associated with an increase in complicated diverticulitis?

See the full guideline for information on these areas. Diverticular disease: antimicrobial prescribing. Download a PDF of this algorithm. Suspect complicated acute diverticulitis and refer for same-day hospital assessment if the person has uncontrolled abdominal pain and any of the features in Table 1.

Altered mental state, raised respiratory rate, low systolic blood pressure, raised heart rate, low tympanic temperature, no urine output or skin discolouration. Sepsis see the NICE guideline on sepsis. Colicky abdominal pain, absolute constipation passage of no flatus or stool , vomiting or abdominal distention.

For information on investigation of suspected acute diverticulitis in secondary care, see the full guideline. For information on the non-surgical managmement of acute diverticulosis, see the diverticular disease antimicrobial prescribing algorithm in this summary. First-choice oral antibiotic for suspected or confirmed uncomplicated acute diverticulitis. Cefalexin caution in penicillin allergy with metronidazole. Cefalexin: mg twice or three times a day up to 1 to 1. Currently there is no medication available to prevent recurrence of diverticulitis.

Although multiple studies have examined rifaximin, probiotics, and 5-aminosalicylic acid mesalamine on diverticulitis recurrences, both AGA and ASCRS found insufficient evidence to support their use. The patient must always be managed as a whole with specific factors taken into account, but trends point toward less use of antibiotics, less emphasis on surgery, all of which brings improved patient outcomes. Skip to main content. Find Doctors Services Locations.

Medical Professionals. Research Community. Medical Learners. Job Seekers. Treatment moves toward less use of antibiotics, less emphasis on surgery Innovations in Digestive Health Winter Colonic diverticulitis remains a painful, unpredictable gastrointestinal disease that can lead to serious complications, chronic symptoms and poor quality of life. Diverticulitis care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version.

This content does not have an Arabic version. Diagnosis Diverticulitis is usually diagnosed during an acute attack. Email address. First Name let us know your preferred name.

Last Name. Thank you for subscribing Your in-depth digestive health guide will be in your inbox shortly. Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Diverticular disease.

Accessed March 27, Diverticula, diverticulosis, diverticulitis: What's the difference?