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International Journal of Colorectal Disease

, Volume 25, Issue 11, pp 1363–1370 | Cite as

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

  • Yolanda RibasEmail author
  • Jordi Bombardó
  • Francesc Aguilar
  • Esther Jovell
  • Manel Alcantara-Moral
  • Francesc Campillo
  • Xavier Lleonart
  • Xavier Serra-Aracil
Original Article

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.

Keywords

Acute diverticulitis Medical treatment Antibiotic Amoxicillin plus clavulanic acid 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Yolanda Ribas
    • 1
    Email author
  • Jordi Bombardó
    • 2
  • Francesc Aguilar
    • 1
  • Esther Jovell
    • 3
  • Manel Alcantara-Moral
    • 2
  • Francesc Campillo
    • 1
  • Xavier Lleonart
    • 1
  • Xavier Serra-Aracil
    • 2
  1. 1.Department of SurgeryConsorci Sanitari de TerrassaTerrassaSpain
  2. 2.Department of SurgeryCorporació Sanitària Parc TaulíSabadellSpain
  3. 3.EpidemiologyConsorci Sanitari de TerrassaTerrassaSpain

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