Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis.

Br J Surg

Colorectal Unit, Department of Surgery, and Centre for Clinical Research Uppsala University, Västmanlands Hospital Västerås, 72189, Västerås, Sweden.

Published: October 2019

Background: The aim of this study was to assess the long-term results in patients with uncomplicated diverticulitis who had participated in the Antibiotics in Acute Uncomplicated Diverticulitis (AVOD) RCT, which randomized patients with CT-verified left-sided acute uncomplicated diverticulitis to management without or with antibiotics.

Methods: The medical records of patients who had participated in the AVOD trial were reviewed for long-term results such as recurrences, complications and surgery. Quality-of-life questionnaires (EQ-5D™) were sent to patients, who were also contacted by telephone. Descriptive statistics were used for the analysis of clinical outcomes.

Results: A total of 556 of the 623 patients (89·2 per cent) were followed up for a median of 11 years. There were no differences between the no-antibiotic and antibiotic group in recurrences (both 31·3 per cent; P = 0·986), complications (4·4 versus 5·0 per cent; P = 0·737), surgery for diverticulitis (6·2 versus 7·1 per cent; P = 0·719) or colorectal cancer (0·4 versus 2·1 per cent; P = 0·061). The response rate for the EQ-5D™ was 52·8 versus 45·2 per cent respectively (P = 0·030), and no differences were found between the two groups in any of the measured dimensions.

Conclusion: Antibiotic avoidance for uncomplicated diverticulitis is safe in the long term.

Download full-text PDF

Source
http://dx.doi.org/10.1002/bjs.11239DOI Listing

Publication Analysis

Top Keywords

uncomplicated diverticulitis
20
antibiotic avoidance
8
avoidance uncomplicated
8
acute uncomplicated
8
diverticulitis
6
cent
6
uncomplicated
5
patients
5
long-term follow-up
4
follow-up avod
4

Similar Publications

Can gut microbiota explain acute diverticulitis occurrence in patients with symptomatic uncomplicated diverticular disease?

Biosci Microbiota Food Health

September 2024

Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.

Why patients with symptomatic uncomplicated diverticular disease (SUDD) may develop acute diverticulitis (AD) is still unknown. We analyzed the gut microbiota (GM) in two SUDD patients, one who did experience SUDD recurrence but not AD occurrence (case 1) and one who did experience AD occurrence during follow-up (case 2). The GM of these patients showed differences in terms of phyla (Firmicutes and Bacteroidota in case 1; Actinobacteriota and Proteobacteria in case 2) and subgenera ( and in case 1 and , , , , group, and in case 2).

View Article and Find Full Text PDF

Background: Little is known about the involvement of gut microbiota in the disease course of diverticulitis and the potential benefits of manipulating the gut milieu. We propose to conduct a randomised placebo-controlled feasibility trial of faecal microbiota transplantation (FMT) given as capsules to patients with acute uncomplicated diverticulitis.

Objectives: The objective is primarily to investigate the feasibility of clinical safety, explore efficacy associated with FMT in this patient population, and examine changes in patient-reported quality of life and the composition and function of the gut microbiota.

View Article and Find Full Text PDF

The role of gut microbiota in the pathogenesis of diverticular disease: where are we now?

Genome Med

December 2024

Department of Medical and Surgical Sciences, Digestive Diseases Centre (CEMAD), Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy.

Diverticular disease (DD) is widespread worldwide. The role of gut microbiota (GM) in DD is not entirely understood.  Here we discuss the significance of the current knowledge on GM in the different stages of DD and how crucial these acquisitions are for designing diagnostic and therapeutic trials in this field.

View Article and Find Full Text PDF

Background: Non-antibiotic outpatient treatment of acute uncomplicated diverticulitis is safe; however, uptake remains low.

Objective: To assess the success of non-antibiotic management of uncomplicated diverticulitis through a nurse clinician-led outpatient program.

Design: Retrospective audit from June 2022-March 2024.

View Article and Find Full Text PDF

Colonic diverticular disease revisited.

Expert Rev Gastroenterol Hepatol

November 2024

Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.

Introduction: Diverticular disease, including diverticulosis and diverticulitis, presents a significant health concern globally, with increasing prevalence in Western societies and emerging trends in Asia. The incidence of diverticulitis, is on the rise, leading to significant morbidity and healthcare costs.

Areas Covered: A literature search was conducted using the PubMed database, and studies published between 1995 and 2024 were selected based on their relevance to the overall understanding of disease.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!