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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 11/2010

01-11-2010 | Original Article

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

Authors: Yolanda Ribas, Jordi Bombardó, Francesc Aguilar, Esther Jovell, Manel Alcantara-Moral, Francesc Campillo, Xavier Lleonart, Xavier Serra-Aracil

Published in: International Journal of Colorectal Disease | Issue 11/2010

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Abstract

Introduction

Medical treatment of uncomplicated acute diverticulitis is not standardized, and there is an enormous diversity in clinical practice. Our aim was to demonstrate that uncomplicated diverticulitis can be managed with orally administered amoxicillin plus clavulanic acid and a short hospital admission.

Methods

A prospective randomized trial was established to compare patients with uncomplicated diverticulitis who received oral antibiotic after a short course of intravenous antibiotic with those who received intravenous antibiotic for a longer period. The antibiotic treatment consisted of amoxicillin plus clavulanic acid 1 g every 8 h. We included 50 patients, 25 in each group. Patients in group 1 began oral antibiotic as soon as they improved and were discharged the day after. Patients in group 2 received intravenous antibiotic for 7 days. Both groups received oral antibiotic at discharge. The endpoint of the study was “failure of treatment,” which was defined as the impossibility of discharging on the expected day, emergency admission, or hospital readmission.

Results

Both groups were comparable in patient demographics and clinical characteristics. Most patients clearly improved between 24 and 48 h after admission. There were no significant differences between the groups when comparing failure of treatment. Treatment of patients in group 1 represented a savings in hospitalization costs of 1,244€ per patient.

Conclusions

Most patients with uncomplicated diverticulitis can be managed safely with oral antibiotic; thus, a very short hospital stay is a safe option.
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Metadata
Title
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
Authors
Yolanda Ribas
Jordi Bombardó
Francesc Aguilar
Esther Jovell
Manel Alcantara-Moral
Francesc Campillo
Xavier Lleonart
Xavier Serra-Aracil
Publication date
01-11-2010
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 11/2010
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-010-0967-9

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