Routine antibiotics unneeded for uncomplicated right colonic diverticulitis

Routine antibiotics may not be required to treat uncomplicated right colonic diverticulitis, a recent South Korea study has found.

Using inpatient data between January 2019 and 2021, the researchers conducted a retrospective comparison of patients who were vs were not treated with antibiotics after propensity score matching at a 1:1 ratio. The primary outcome was the length of hospital stay, while secondary endpoints were the time to introduction of sips of water and a soft diet.

After matching, each group included 55 patients with no significant differences in characteristics. Outcomes were comparable, too, with the mean length of hospital stay being 3.02±0.95 and 3.11±0.79 days in the antibiotic and control groups, respectively (p=0.586).

Similarly, the time to sips of water was not significantly different between the antibiotic and control groups, taking a mean of 2.1±0.7 and 1.8±0.9 days, respectively (p=0.100). The same was true for time to soft diet (2.4±0.8 vs 2.1±0.9 days, respectively; p=0.125). Laboratory findings likewise did not reveal a significant impact of antibiotic medication.

During follow-up (mean 229.3±21.9 days), recurrence of diverticulitis occurred in 3.6 percent (n=2) of controls and in 10.9 percent (n=6) of patients in the antibiotic group (p=0.271).

“Routine antibiotics did not affect the length of hospital stay in this cohort. Therefore, routine antibiotics may be not required for treating patients with uncomplicated right colonic diverticulitis,” the researchers said. “However, considering the limitations of our study, a multicentre large-scale prospective study is necessary.”