The Use of Antibiotics in Diverticulitis: An Update in Non-operative Management

Abstract

Diverticulosis is a common disease among Western and developed nations. Approximately 20% of patients with diverticulosis will become symptomatic. Acute diverticulitis is a common manifestation of diverticular disease. Different classifications exist to try to categorize it but, it is generally considered as complicated or uncomplicated. Eighty-five percent of patients with an acute onset of diverticulitis will have an uncomplicated presentation. The best way to assess the degree and severity of the disease is a CT scan along with some biochemical parameters like CRP. Recent guidelines from associations all over the world accept non-antibiotic therapy as a valid strategy of treatment for the non-complicated diverticulitis. Antibiotics are still compulsory in immune-compromised patients, the elderly, those with comorbidities, and those with signs of sepsis. Recommendations should be made on a case-by-case basis.