Comparative Effectiveness and Harms of Antibiotics for Outpatient Diverticulitis
Authors: Charles E. Gaber, Alan C. Kinlaw, Anne F. Peery
Journal: Annals of Internal Medicine (2022)

LettersMarch 2022Comparative Effectiveness and Harms of Antibiotics for Outpatient DiverticulitisCharles E. Gaber, MPH, Alan C. Kinlaw, PhD, MSPH, Anne F. Peery, MD, MSCRCharles E. Gaber, MPHCenter for Gastrointestinal Biology and Disease, University of North Carolina School of Medicine, and School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaSearch for more papers by this author, Alan C. Kinlaw, PhD, MSPHUniversity of North Carolina School of Pharmacy and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaSearch for more papers by this author, Anne F. Peery, MD, MSCRCenter for Gastrointestinal Biology and Disease, University of North Carolina School of Medicine, Chapel Hill, North CarolinaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0008 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: Drs. Shah and McGowan question whether any antibiotic treatment is necessary for patients with acute uncomplicated diverticulitis in the outpatient setting. Ten years ago, the answer to this question was easy: The standard of care was to treat all patients with acute uncomplicated diverticulitis with a course of antibiotics. The answer now is more complicated.In the past decade, a handful of trials have questioned the practice of treating acute uncomplicated diverticulitis with antibiotics (1, 2). These provocative but objectively limited trials were designed to assess whether antibiotics expedite recovery from the acute episode. With some confidence, we ...References1. Chabok A, Påhlman L, Hjern F, et al; AVOD Study Group. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012;99:532-9. [PMID: 22290281] doi:10.1002/bjs.8688 CrossrefMedlineGoogle Scholar2. Daniels L, Ünlü Ç, de Korte, et al; Dutch Diverticular Disease (3D) Collaborative Study Group. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg. 2017;104:52-61. [PMID: 27686365] doi:10.1002/bjs.10309 CrossrefMedlineGoogle Scholar3. Balk EM, Adam GP, Cao W, et al. Management of Colonic Diverticulitis. Comparative Effectiveness Review No. 233. (Prepared by the Brown Evidence-based Practice Center under Contract No. 290-2015- 00002-I.) AHRQ Publication No. 20(21)-EHC025. Agency for Healthcare Research and Quality; October 2020. Google Scholar4. Stollman N, Smalley W, Hirano I; AGA Institute Clinical Guidelines Committee. American Gastroenterological Association Institute guideline on the management of acute diverticulitis. Gastroenterology. 2015;149:1944-9. [PMID: 26453777] doi:10.1053/j.gastro.2015.10.003 CrossrefMedlineGoogle Scholar5. Peery AF, Shaukat A, Strate LL. AGA clinical practice update on medical management of colonic diverticulitis: expert review. Gastroenterology. 2021;160:906-11. [PMID: 33279517] doi:10.1053/j.gastro.2020.09.059 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Center for Gastrointestinal Biology and Disease, University of North Carolina School of Medicine, and School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaUniversity of North Carolina School of Pharmacy and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaCenter for Gastrointestinal Biology and Disease, University of North Carolina School of Medicine, Chapel Hill, North CarolinaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-6315. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Effectiveness and Harms of Antibiotics for Outpatient Diverticulitis Charles E. Gaber , Alan C. Kinlaw , Jessie K. Edwards , Jennifer L. Lund , Til Stürmer , Sharon Peacock Hinton , Virginia Pate , Luther A. Bartelt , Robert S. Sandler , and Anne F. Peery Comparative Effectiveness and Harms of Antibiotics for Outpatient Diverticulitis Nishit Shah and Joseph McGowan Metrics Cited byPostoperative Use of Biologics Was Less Common Among Patients With Crohn’s Disease With Emergent/Urgent vs Elective Intestinal Resection March 2022Volume 175, Issue 3Page: W25-W26 ePublished: 15 March 2022 Issue Published: March 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...