title: Outpatient, non-antibiotic management in acute uncomplicated diverticulitis: a prospective study.
abstract: OBJECTIVE
  The aim of this study was to evaluate outpatient, non-antibiotic management in acute uncomplicated diverticulitis with regard to admissions, complications, and recurrences, within a 3-month follow-up period.
  
  
  METHODS
  A prospective, observational study in which patients with computer tomography-verified acute uncomplicated diverticulitis were managed as outpatients without antibiotics. The patients kept a personal journal, were contacted daily by a nurse, and then followed up by a surgeon at 1 week and 3 months.
  
  
  RESULTS
  In total, 155 patients were included, of which 54 were men; the mean age of the patients was 57.4 years. At the time of diagnosis, the mean C-reactive protein and white blood cell count were 73 mg/l and 10.5 × 10(9), respectively, and normalized in the vast majority of patients within the first week. The majority of the patients (97.4%) were managed successfully as outpatients without antibiotics, admissions, or complications. In only four (2.6%) patients, the management failed because of complications in three and deterioration in one. These patients were all treated successfully as inpatients without surgery. Five patients had recurrences and were treated as outpatients without antibiotics. Follow-up colonic investigations revealed cancer in two patients and polyps in 13 patients.
  
  
  CONCLUSIONS
  Previous results of low complication rates with the non-antibiotic policy were confirmed. The new policy of outpatient management without antibiotics in acute uncomplicated diverticulitis is now shown to be feasible, well functioning, and safe.
authors.affiliation: Colorectal Unit, Department of Surgery, Västmanland's Hospital Västerås, SE-72189, Västerås, Sweden, ddisacson@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Isacson
authors.forename: A
authors.initials: A
authors.lastname: Thorisson
authors.forename: K
authors.initials: K
authors.lastname: Andreasson
authors.forename: M
authors.initials: M
authors.lastname: Nikberg
authors.forename: K
authors.initials: K
authors.lastname: Smedh
authors.forename: A
authors.initials: A
authors.lastname: Chabok
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D015746:Abdominal Pain / Q000209:etiology; D000082:Acetaminophen / Q000627:therapeutic use*; D000208:Acute Disease; D000368:Aged; D000553:Ambulatory Care; D000700:Analgesics / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D004032:Diet; D018450:Disease Progression; D004239:Diverticulitis, Colonic / Q000097:blood / Q000150:complications / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
chemical_list: D000700:Analgesics; D000082:Acetaminophen; D002097:C-Reactive Protein