Clinical Question

Does antibiotic therapy for acute uncomplicated diverticulitis reduce complications or the need for emergency surgery?

Evidence-Based Answer

Antibiotics do not reduce complications or the need for emergency surgery in people with acute uncomplicated diverticulitis. Treatment without antibiotics appears to be safe.¹ (Strength of Recommendation: B, meta-analysis of lower-quality randomized controlled trials [RCTs].)

Practice Pointers

Acute uncomplicated diverticulitis occurs in approximately 4% of people with colonic diverticulosis and has traditionally been considered a bacterial infection that should be treated with antibiotics.² Risk factors for diverticulitis (e.g., smoking, obesity, red meat consumption) suggest that chronic inflammation is a potential etiology, which has led some clinicians to question the utility of antibiotics.³ The authors of this Cochrane review sought to determine if antibiotic treatment of acute uncomplicated diverticulitis reduces complications or the need for emergency surgery.