title: Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis.
abstract: BACKGROUND
  The standard of care for acute uncomplicated diverticulitis today is antibiotic treatment, although there are no controlled studies supporting this management. The aim was to investigate the need for antibiotic treatment in acute uncomplicated diverticulitis, with the endpoint of recovery without complications after 12 months of follow-up.
  
  
  METHODS
  This multicentre randomized trial involving ten surgical departments in Sweden and one in Iceland recruited 623 patients with computed tomography-verified acute uncomplicated left-sided diverticulitis. Patients were randomized to treatment with (314 patients) or without (309 patients) antibiotics.
  
  
  RESULTS
  Age, sex, body mass index, co-morbidities, body temperature, white blood cell count and C-reactive protein level on admission were similar in the two groups. Complications such as perforation or abscess formation were found in six patients (1·9 per cent) who received no antibiotics and in three (1·0 per cent) who were treated with antibiotics (P = 0·302). The median hospital stay was 3 days in both groups. Recurrent diverticulitis necessitating readmission to hospital at the 1-year follow-up was similar in the two groups (16 per cent, P = 0·881).
  
  
  CONCLUSIONS
  Antibiotic treatment for acute uncomplicated diverticulitis neither accelerates recovery nor prevents complications or recurrence. It should be reserved for the treatment of complicated diverticulitis.
authors.affiliation: Colorectal Unit, Department of Surgery, and Centre for Clinical Research Uppsala University, Västmanlands Hospital, Västerås, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Chabok
authors.forename: L
authors.initials: L
authors.lastname: Påhlman
authors.forename: F
authors.initials: F
authors.lastname: Hjern
authors.forename: S
authors.initials: S
authors.lastname: Haapaniemi
authors.forename: K
authors.initials: K
authors.lastname: Smedh
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism; D004239:Diverticulitis, Colonic / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D004359:Drug Therapy, Combination; D004638:Emergency Treatment; D005260:Female; D005334:Fever / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein