Need for Antibiotics in Cases of Acute Uncomplicated Diverticulitis: A Meta-Analysis of Conservative Versus Antibiotic Treatment Approaches Article Swipe
Gaurav Maheshwari
,
Sadaf Khalid
,
A Ansari
,
Ahmed Elmoraly
,
Arshad Javaid
,
Muhammad Ali Mumtaz
,
Zulfiqar Ali
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.7759/cureus.86951
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.7759/cureus.86951
Acute uncomplicated diverticulitis (AUD) is often treated with antibiotics, though recent evidence questions their necessity in clinically stable patients. Concerns over antibiotic resistance have prompted consideration of conservative, non-antibiotic management, but clinical equivalence remains debated. This study aimed to compare antibiotic versus non-antibiotic management for CT (computed tomography)-confirmed AUD in adults, focusing on outcomes like mortality, complications, recurrence, surgery, and length of hospital stay (LOS). A systematic search (2016-2025) was carried out across five databases, identifying randomized controlled trials (RCTs) comparing antibiotic to conservative treatment in patients with Hinchey 1a/1b or Modified Neff grade 0 diverticulitis. Two reviewers independently extracted data and assessed bias using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcomes were analyzed using a DerSimonian-Laird random-effects model. Seven RCTs (n = 8,035) met inclusion criteria. No significant differences were found in mortality (odds ratio (OR) 1.06; 95% CI: 0.71-1.58), complications (OR 0.67; 95% CI: 0.27-1.67), emergency surgery (OR 0.60; 95% CI: 0.23-1.54), or recurrence (OR 0.96; 95% CI: 0.65-1.44). LOS was marginally shorter in the conservative group. Heterogeneity for mortality and LOS was moderate (I² = 43.2%). Most studies defined clinical stability based on the absence of systemic signs and CT-confirmed localized inflammation; some variations in diagnostic criteria were noted. Conservative treatment without antibiotics in select AUD patients yields comparable outcomes to antibiotic use. These findings support guideline recommendations favoring selective antibiotic use, though heterogeneity in population definitions and short follow-up in some studies should be noted.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.7759/cureus.86951
- https://www.cureus.com/articles/365716-need-for-antibiotics-in-cases-of-acute-uncomplicated-diverticulitis-a-meta-analysis-of-conservative-versus-antibiotic-treatment-approaches.pdf
- OA Status
- diamond
- References
- 34
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4411762838
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4411762838Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.7759/cureus.86951Digital Object Identifier
- Title
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Need for Antibiotics in Cases of Acute Uncomplicated Diverticulitis: A Meta-Analysis of Conservative Versus Antibiotic Treatment ApproachesWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-06-29Full publication date if available
- Authors
-
Gaurav Maheshwari, Sadaf Khalid, A Ansari, Ahmed Elmoraly, Arshad Javaid, Muhammad Ali Mumtaz, Zulfiqar AliList of authors in order
- Landing page
-
https://doi.org/10.7759/cureus.86951Publisher landing page
- PDF URL
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https://www.cureus.com/articles/365716-need-for-antibiotics-in-cases-of-acute-uncomplicated-diverticulitis-a-meta-analysis-of-conservative-versus-antibiotic-treatment-approaches.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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diamondOpen access status per OpenAlex
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https://www.cureus.com/articles/365716-need-for-antibiotics-in-cases-of-acute-uncomplicated-diverticulitis-a-meta-analysis-of-conservative-versus-antibiotic-treatment-approaches.pdfDirect OA link when available
- Concepts
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Medicine, Antibiotics, Diverticulitis, Meta-analysis, Conservative treatment, Intensive care medicine, Intravenous antibiotics, Internal medicine, Surgery, Microbiology, BiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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34Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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