Diverticulitis
[Gastroenterology 2021;160:906-11]
Acute uncomplicated with no risk factors* – Antibiotics not generally recommended
Acute uncomplicated with risk factors* - Antibiotic treatment recommended
*Risk factors:
- multiple/significant co-morbidities
- symptom duration > 5 days
- vomiting
- CRP > 140mg/L
- WBC > 15x109/L
- fluid collection
- inflammation on CT scan > 86mm
Polymicrobial:
Enterobacterales
Anaerobes
Enterococcus spp
Acute uncomplicated with risk factors*
| Empiric Therapy | Dose | Duration |
|---|---|---|
| [TMP/SMX | 1 DS tab PO bid | 4-7 days |
| + | ||
| Metronidazole] | 500mg PO bid | |
| or | ||
| Amoxicillin-clavulanate | 875mg PO bid | 4-7 days |
| or | ||
| [Ciprofloxacin | 500mg PO bid | 4-7 days |
| + | ||
| Metronidazole] | 500mg PO bid |
Complicated: abscess, perforation/peritonitis, obstruction, stricture and/or fistula, or immunocompromised - treat as 2° peritonitis
See 2° Peritonitis