Which medications are used to treat diverticulitis?

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

Diverticulosis is treated with lifelong dietary modification. However, antibiotics have been the mainstay of therapy for most patients with acute diverticulitis, but more recently, their necessity has been questioned, especially in mild, uncomplicated disease. [4, 31] It appears that antimicrobial use in acute uncomplicated diverticulitis increases patients' stay in the hospital without lowering the overall or individual complication rates. [32] Other studies have shown that the effectiveness of single- or multiple-agent antibiotic regimens for outpatient therapy are essentially the same when they provide both anaerobic and aerobic coverage. [6, 7]

Empiric therapy requires broad-spectrum antibiotics effective against known enteric pathogens. For complicated cases of diverticulitis in hospitalized patients, carbapenems are the most effective empiric therapy because of increasing bacterial resistance to other regimens.

Potential regimens include the following:

  • Ciprofloxacin plus metronidazole
  • Trimethoprim-sulfamethoxazole plus metronidazole
  • Amoxicillin-clavulanate
  • Moxifloxacin (use in patients intolerant of both metronidazole and beta lactam agents)

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