SettingRegimen
PrimaryAlternative
Outpatient (mild)Not recommended in mild, uncomplicated diverticulitis; recent trials suggest that taking no antibiotics is an option with appropriate follow-up23,24
Outpatient (mild, but with persistent or worsening symptoms)

  • Trimethoprim/sulfamethoxazole DS, 160/800 mg orally every 12 hours

    or

    Ciprofloxacin (Cipro), 750 mg orally every 12 hours, or levofloxacin (Levaquin), 750 mg orally every 24 hours, plus metronidazole (Flagyl), 500 mg orally every six hours

  • Amoxicillin/clavulanate extended release (Augmentin XR), two 1,000/62.5-mg tablets orally every 12 hours

    or

    Moxifloxacin (Avelox), 400 mg orally every 24 hours

Inpatient (mild to moderate)

  • Piperacillin/tazobactam (Zosyn), 3.375 g IV every six hours or 4.5 g IV every eight hours

    or

    Ticarcillin/clavulanate (Timentin), 3.1 g IV every six hours

    or

    Ertapenem (Invanz), 1 g IV every 24 hours

    or

    Moxifloxacin, 400 mg IV every 24 hours

  • Ciprofloxacin, 400 mg IV every 12 hours, or levofloxacin, 750 mg IV every 24 hours, plus metronidazole, 500 mg IV every six hours or1 g IV every 12 hours

    or

    Tigecycline (Tygacil), 100 mg IV first dose, then 50 mg IV every 12 hours

    or

    Moxifloxacin, 400 mg IV every 24 hours

Severe (life-threatening)

  • Imipenem/cilastatin (Primaxin), 500 mg IV every six hours

    or

    Meropenem (Merrem), 1 g IV every eight hours

    or

    Doripenem (Doribax), 500 mg IV every eight hours

  • Ampicillin, 2 g IV every six hours, plus metronidazole, 500 mg IV every six hours, plus ciprofloxacin, 400 mg IV every 12 hours, or levofloxacin, 750 mg IV every 24 hours

    or

    Ampicillin, 2 g IV every six hours, plus metronidazole, 500 mg IV every six hours, plus amikacin, gentamicin, or tobramycin