ABSTRACT
Aim: To confirm safety of treatment of acute uncomplicated diverticulitis (AUD) without antibiotics, developing a standarized protocol for selected patients. Method(s): Prospective observational multicentre study carried out between january 1st 2021 and april 15th 2022. Inclusion criteria: Age between 18 and 80, AUD diagnosed by computarized tomography (CT), adequate family support and cognitive capacity, good symptom control, adequate oral intake, signed informed consent. Exclusion criteria: diabetes mellitus, cardiologic event in the last 3 months, chronic liver disease, advanced chronic renal failure, active neoplasic pathology, HIV active infection, corticoidsteroid or immunosuppresant therapy, transplant, splenectomy, inflamatory bowel disease, previous episode of diverticulitis during last 3 months and antibiotic treatment during last 2weeks. Maximum 1 of the following: T >38degreeC-<36degreeC, L >12,000/ml-<4000/ ml, heart rate>90 bpm, CPR >15 mg/dL. Patients were proposed to take part of the study and those who accepted were treated as outpatient with ibuprofen 600mg/8 h, paracetamol 1 g/8 h and omeprazol 40 mg/24h during 7days. Follow-up was carried out by telephone during first 24 h, and attending the emergency department at 48 h and at 7days. Result(s): 157 patients were diagnosed of acute diverticulits, 132 were Hinchey Ia, with 37 (28.1%) patients that fullfilled criteria for the study. 67.6% of patients were male, with median age of 57.6+/-9.7years. Among 37 patients included in the study, 36 were contacted by telephone 24 h. after first visit to emergency department. Only one of them had fever 48 h after diagnosis all patients were clinically reevaluated and only two of them needed a change of strategy, one because of fever, so we started antibiotic therapy and the other because COVID-19 infection. None of the patients needed urgent surgical intervention nor hospitalisation during the study and follow up. Conclusion(s): Our results confirm that treatment of AUD without antibiotics in selected patients is safe.