دورية أكاديمية
أعرض في EDS

Oral versus intravenous antibiotics in the treatment of uncomplicated colonic diverticulitis: results of a randomized non-inferiority control trial.

التفاصيل البيبلوغرافية
العنوان: Oral versus intravenous antibiotics in the treatment of uncomplicated colonic diverticulitis: results of a randomized non-inferiority control trial.
المؤلفون: McClintock S; Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Stupart D; Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Hoh SM; Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Redden AM; Hospital in the Home (HITH), University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Schultz B; Hospital in the Home (HITH), University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Robertson A; Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Moore E; Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Pollard J; Hospital in the Home (HITH), University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Guest G; Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia., Watters D; Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.
المصدر: ANZ journal of surgery [ANZ J Surg] 2024 Mar; Vol. 94 (3), pp. 397-403. Date of Electronic Publication: 2023 Nov 14.
نوع المنشور: Randomized Controlled Trial; Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Publishing Asia Country of Publication: Australia NLM ID: 101086634 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1445-2197 (Electronic) Linking ISSN: 14451433 NLM ISO Abbreviation: ANZ J Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: Carlton, Victoria, Australia : Wiley-Blackwell Publishing Asia
Original Publication: Carlton, Victoria, Australia : Blackwell Science Asia on behalf of the Royal Australasian College of Surgeons, c2001-
مواضيع طبية MeSH: Diverticulitis, Colonic*/drug therapy , Diverticulitis* , Diverticulosis, Colonic*, Humans ; Anti-Bacterial Agents/therapeutic use ; Pain ; Acute Disease ; Treatment Outcome
مستخلص: Background: Colonic diverticular disease is common and its incidence increases with age, with uncomplicated diverticulitis being the most common acute presentation (1). This typically results in inpatient admission, placing a significant burden on healthcare services (2). We aimed to determine the safety and effectiveness of using intravenous or oral antibiotics in the treatment of uncomplicated diverticulitis on 30-day unplanned admissions, c-reactive protein (CRP), White Cell Count (WCC), pain resolution, cessation of pain medication, return to normal nutrition, and return to normal bowel function.
Methods: This single centre, 2-arm, parallel, 1:1, unblinded non-inferiority randomized controlled trial compared the safety and efficacy of oral antibiotics versus intravenous antibiotics in the outpatient treatment of uncomplicated colonic diverticulitis. Inclusion criteria were patients older than 18 years of age with CT proven acute uncomplicated colonic diverticulitis (Modified Hinchey Classification Stage 0-1a). Patients were randomly allocated receive either intravenous or oral antibiotics, both groups being treated in the outpatient setting with a Hospital in the Home (HITH) service. The primary outcome was the 30-day unplanned admission rate, secondary outcomes were biochemical markers, time to pain resolution, time to cessation of pain medication, time to return to normal function and time to return to normal bowel function.
Results: In total 118 patients who presented with uncomplicated colonic diverticulitis were recruited into the trial. Fifty-eight participants were treated with IV antibiotics, and 60 were given oral antibiotics. We found there was no significant difference between groups with regards to 30-day unplanned admissions or inflammatory markers. There was also no significant difference with regards to time to pain resolution, cessation of pain medication use, return to normal nutrition, or return to normal bowel function.
Conclusion: Outpatient management of uncomplicated diverticulitis with oral antibiotics proved equally as safe and efficacious as intravenous antibiotic treatment in this randomized non-inferiority control trial.
(© 2023 Royal Australasian College of Surgeons.)
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فهرسة مساهمة: Keywords: antibiotics; colonic diverticulitis; diverticular disease; diverticulitis; uncomplicated diverticulitis
المشرفين على المادة: 0 (Anti-Bacterial Agents)
تواريخ الأحداث: Date Created: 20231114 Date Completed: 20240320 Latest Revision: 20240320
رمز التحديث: 20240320
DOI: 10.1111/ans.18768
PMID: 37962086
قاعدة البيانات: MEDLINE
الوصف
تدمد:1445-2197
DOI:10.1111/ans.18768