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Outpatient, non-antibiotic management in acute uncomplicated diverticulitis: a prospective study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanlands Hosp Vasteras, Colorectal Unit, Dept Surg, SE-72189 Vasteras, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanlands Hosp Vasteras, Dept Radiol, SE-72189 Vasteras, Sweden..
Vastmanlands Hosp Vasteras, Colorectal Unit, Dept Surg, SE-72189 Vasteras, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanlands Hosp Vasteras, Colorectal Unit, Dept Surg, SE-72189 Vasteras, Sweden..
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2015 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 30, no 9, 1229-1234 p.Article in journal (Refereed) Published
Abstract [en]

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. 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. 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 x 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. 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.

Place, publisher, year, edition, pages
2015. Vol. 30, no 9, 1229-1234 p.
Keyword [en]
Diverticulitis, Outpatient management, Antibiotics
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Clinical Medicine
Identifiers
URN: urn:nbn:se:uu:diva-262965DOI: 10.1007/s00384-015-2258-yISI: 000360542000011PubMedID: 25989930OAI: oai:DiVA.org:uu-262965DiVA: diva2:856395
Note

Correction in: International Journal of Colorectal Disease, 2015, vol. 30, issue 9, pages 1225-1235, doi: 10.1007/s00384-015-2284-9

Available from: 2015-09-24 Created: 2015-09-23 Last updated: 2017-12-01Bibliographically approved

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Isacson, DanielThorisson, ArnarNikberg, MaziarSmedh, KennetChabok, Abbas

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Health Care Service and Management, Health Policy and Services and Health EconomyClinical Medicine

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