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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 9/2015

01-09-2015 | Original Article

Outpatient, non-antibiotic management in acute uncomplicated diverticulitis: a prospective study

Authors: D. Isacson, A. Thorisson, K. Andreasson, M. Nikberg, K. Smedh, A. Chabok

Published in: International Journal of Colorectal Disease | Issue 9/2015

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Abstract

Purpose

The aim of this study was to evaluate outpatient, non-antibiotic management in acute uncomplicated diverticulitis with regard to admissions, complications, and recurrences, within a 3-month follow-up period.

Methods

A prospective, observational study in which patients with computer tomography-verified acute uncomplicated diverticulitis were managed as outpatients without antibiotics. The patients kept a personal journal, were contacted daily by a nurse, and then followed up by a surgeon at 1 week and 3 months.

Results

In total, 155 patients were included, of which 54 were men; the mean age of the patients was 57.4 years. At the time of diagnosis, the mean C-reactive protein and white blood cell count were 73 mg/l and 10.5 × 109, respectively, and normalized in the vast majority of patients within the first week. The majority of the patients (97.4 %) were managed successfully as outpatients without antibiotics, admissions, or complications. In only four (2.6 %) patients, the management failed because of complications in three and deterioration in one. These patients were all treated successfully as inpatients without surgery. Five patients had recurrences and were treated as outpatients without antibiotics. Follow-up colonic investigations revealed cancer in two patients and polyps in 13 patients.

Conclusion

Previous results of low complication rates with the non-antibiotic policy were confirmed. The new policy of outpatient management without antibiotics in acute uncomplicated diverticulitis is now shown to be feasible, well functioning, and safe.
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Metadata
Title
Outpatient, non-antibiotic management in acute uncomplicated diverticulitis: a prospective study
Authors
D. Isacson
A. Thorisson
K. Andreasson
M. Nikberg
K. Smedh
A. Chabok
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 9/2015
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-015-2258-y

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