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The Growing Uncertainty of the Benefits of Antibiotics in Diverticulitis

– Re-examining the role of antibiotics in treating uncomplicated diverticulitis


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Diverticulitis is a common problem, inspiring both frequent inpatient and outpatient consultations with gastroenterologists. As such, we often serve an important role in coordinating care for these patients. I find that this often involves close communication with both our primary care and surgical colleagues. In this role, it is paramount to maintain a contemporary understanding of the principles of diverticulitis management.

The accompanying study in aimed to assess the non-inferiority of placebo compared with antibiotic-based management of uncomplicated diverticulitis. This study contributes to a body of literature that re-examines the role that antibiotics play in the clinical care of this subset within the disease spectrum of diverticulitis.

The authors highlighted the differences across international guidelines that address diverticular disease management, reflecting the growing uncertainty of the benefits antibiotics confer in uncomplicated cases, as supported by the findings of this study. The evidence and discussion presented in the study will enrich the future conversations I share with my colleagues and patients regarding the options for uncomplicated diverticulitis management. This study is particularly germane in an era of increasing antimicrobial stewardship awareness and offers a glimpse at future opportunities for evolution of thought within our field of practice.

Bradley W. Anderson, MD, is a gastroenterology and hepatology fellow at the Mayo Clinic in Rochester, Minnesota.

You can read an interview with study author Ian Bissett, MD, here and read the abstract of the study here.

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Clinical Gastroenterology and Hepatology

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