What are the treatment options for mild diverticulitis?

Updated: Aug 06, 2019
  • Author: Elie M Ghoulam, MD, MS; Chief Editor: BS Anand, MD  more...
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Outpatient treatment of diverticulitis

Patients with mild diverticulitis, typically with Modified Hinchey stage 0 and Ia disease, can be started on an outpatient treatment regimen. This consists of a clear liquid diet and 7-10 days of an oral (PO) broad-spectrum antimicrobial regimen that covers anaerobic microorganisms, such as Bacteroides fragilis and Peptostreptococcus and Clostridium organisms, as well as aerobic microorganisms, such as Escherichia coli and Klebsiella, Proteus, Streptococcus, and Enterobacter organisms. Single and multiple antibiotic regimens are equally effective as long as both groups of organisms are covered. [6, 7] According to the World Gastroenterology Organisation (WGO) 2007 practice guidelines for diverticular disease, such a regimen should result in improvement within 48-72 hours. [1] Note the following:

  • A typical oral antibiotic regimen is a combination of ciprofloxacin (or trimethoprim-sulfamethoxazole) and metronidazole. Monotherapy with moxifloxacin or amoxicillin/clavulanic acid are appropriate for outpatient treatment of uncomplicated diverticulitis.

  • Instruct patients about being on a clear liquid diet only, and that they can slowly advance the diet as tolerated after clinical improvement, which usually occurs within 2-3 days.

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