[Applicability, safety and efficacy of an ambulatory treatment protocol in patients with uncomplicated acute diverticulitis].
BACKGROUND
The aim of this study was to evaluate the applicability, safety and efficacy of an ambulatory treatment protocol in patients with uncomplicated acute diverticulitis.


METHODS
All patients diagnosed with uncomplicated acute diverticulitis based on abdominal computed tomography findings during a 2-year period were prospectively included. Patients with vomiting, severe comorbidities, or without an appropriate family environment were excluded. Ambulatory treatment consisted of oral antibiotics for 1 week (amoxicillin-clavulanic 1 g t.i.d. or ciprofloxacin 500 mg b.i.d. plus metronidazole 500 mg t.i.d. in patients with penicillin allergy). A clear liquid diet for the first 2 days and pain control with oral acetaminophen 1 g t.i.d. were also recommended.


RESULTS
Fifty-three patients were diagnosed with uncomplicated acute diverticulitis and 13 patients were excluded. Therefore, ambulatory treatment was initiated in 40 patients. Only two patients (5%) required admission after outpatient therapy was started due to vomiting and persistent abdominal pain, respectively. In both patients, the inflammatory process was successfully resolved by intravenous antibiotic treatment. In the remaining 38 patients (95%), ambulatory treatment was completed without complications.


CONCLUSIONS
Ambulatory treatment of uncomplicated acute diverticulitis is safe, effective and applicable in most patients with tolerance to oral intake and with an appropriate family environment.
Peláez
Núria
N
Unidad de Cirugía Colorrectal. Servicio de Cirugía General. Hospital del Mar. Barcelona. España.
Pera
Miguel
M
Courtier
Ricard
R
Sánchez
Juan
J
Gil
M José
MJ
Parés
David
D
Grandea
Luis
L
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D004238:Diverticulitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D011860:Radiography, Abdominal; D012449:Safety; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D002939:Ciprofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination