We want to share this important Cochrane review: Antibiotics for uncomplicated diverticulitis.

Objectives: The objectives of this systematic review were to determine if antibiotic treatment of uncomplicated acute diverticulitis affects the risk of complications (immediate or late) or the need for emergency surgery.

Main results:
The authors included 5 randomized controlled trials.
Three compared no antibiotics to antibiotics, one compared double to single compound antibiotics, and one study compared long versus short-term of intravenous antibiotics.

Antibiotics vs no antibiotics:

• Short‐term complications: There may be little or no difference (RR 0.89; 95% CI 0.30 to 2.62; 3 studies, 1329 participants; low‐certainty evidence)
• Emergency surgery <30 days: May be lower with no antibiotics compared to antibiotics (RR 0.47; 95% CI 0.13, 1.71; 1329 participants; 3 studies; low‐certainty evidence)

Double compound vs. single compound antibiotics:

• Uncertain clinical effect

Short versus long intravenous administration of antibiotics:

• No events were reported for the primary outcome of the review

Authors' conclusions
The evidence on antibiotic treatment for uncomplicated acute diverticulitis suggests that the effect of antibiotics is uncertain for complications, emergency surgery, recurrence, elective colonic resections, and long‐term complications. The quality of the evidence is low. Only three RCTs on the need for antibiotics are currently available. More trials are needed to obtain more precise effect estimates.

Access publication here: https://doi.org/10.1002/14651858.CD009092.pub3