Paucis Verbis: Outpatient treatment for diverticulitis

The classic teaching for the treatment of diverticulitis includes:

• Hospital admission
• Bowel rest (NPO)
• IV fluids
• Broad spectrum IV antibiotics

Do ALL patients need to be admitted? There is some early literature suggesting that there is a small sub-population who fare well with outpatient treatment.

This article from Annals of EM in the "Best Available Evidence" series summarizes the existing literature well. Plus, I was one of the journal reviewers for the article and am thrilled to see this coming out in print finally.

[MS Word] [PDF]

See other Paucis Verbis cards.

Word of caution: This paper only provides guidelines, based on the limited evidence out there. Still use your common sense. For instance, I'd still admit patients who are elderly (>80 years old) or have evidence of any perforation on CT. If on the fence, admit the patient.

Still it's nice to see that the treatment of uncomplicated diverticulitis on an outpatient basis has some supporting literature.

Reference
Friend K, Mills AM. Is Outpatient Oral Antibiotic Therapy Safe and Effective for the Treatment of Acute Uncomplicated Diverticulitis? Annals of Emergency Medicine. 2011 - in early press. DOI: 10.1016/j.annemergmed.2010.11.008