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Am Fam Physician. 2023;108(3):237-238

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

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.

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These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.

A collection of Cochrane for Clinicians published in AFP is available at

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