ArticleInternational journal of colorectal disease2018
Treatment of acute uncomplicated diverticulitis without antibiotics: risk factors for treatment failure.
Article in International journal of colorectal disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06517264 (Multicenter Clinical Trial on the Effectiveness and Safety of Outpatient Treatment of Uncomplicated Acute Diverticulitis Without Antibiotics Compared to Treatment With Antibiotics. ADIANA TRIAL), which is not on this map. Cited by 10 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multicenter Clinical Trial on the Effectiveness and Safety of Outpatient Treatment of Uncomplicated Acute Diverticulitis Without Antibiotics Compared to Treatment With Antibiotics. ADIANA TRIAL
Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- SAGES white paper on antibiotic omission in the management of acute uncomplicated diverticulitis: why, when, who, and most importantly, how.Surgical endoscopy · 2025Guideline
- Systematic review and meta-analysis of the management of acute uncomplicated diverticulitis: time to change traditional practice.International journal of colorectal disease · 2024Pooled it
- German guideline diverticular disease/diverticulitis: Part II: Conservative, interventional and surgical management.United European gastroenterology journal · 2022Guideline
- Evidence-based clinical practice guidelines for diagnosis and medical management of acute colonic diverticulitis developed by the Korean Association for the Study of Intestinal Diseases (KASID).Intestinal research · 2026Review
- Article
- C-reactive protein and digestive pathologies: A narrative review for daily clinical use.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2025Review
- Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence.Clinics in colon and rectal surgery · 2024Review
- Management of acute uncomplicated diverticulitis without antibiotics: compliance and outcomes -a retrospective cohort study.BMC emergency medicine · 2022Article
- The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
- Drains, Germs, or Steel: Multidisciplinary Management of Acute Colonic Diverticulitis.Digestive diseases and sciences · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeConservative treatment strategy without antibiotics in patients with uncomplicated diverticulitis (UD) has proven to be safe. The aim of the current study is to assess the clinical course of UD patients who were initially treated without antibiotics and to identify risk factors for treatment failure.
methodsA retrospective cohort study was performed including all patients with a CT-proven episode of UD (defined as modified Hinchey 1A). Only non-immunocompromised patients who presented without signs of sepsis were included. Patients that received antibiotics within 24 h after or 2 weeks prior to presentation were excluded from analysis. Patient characteristics, clinical signs, and laboratory parameters were collected. Treatment failure was defined as (re)admittance, mortality, complications (perforation, abscess, colonic obstruction, urinary tract infection, pneumonia) or need for antibiotics, operative intervention, or percutaneous abscess drainage within 30 days after initial presentation. Multivariable logistic regression analyses were used to quantify which variables are independently related to treatment failure.
resultsBetween January 2005 and January 2017, 751 patients presented at the emergency department with a CT-proven UD. Of these, 186 (25%) patients were excluded from analysis because of antibiotic treatment. A total of 565 patients with UD were included. Forty-six (8%) patients experienced treatment failure. In the multivariable analysis, a high CRP level (> 170 mg/L) was a significant predictive factor for treatment failure.
conclusionUD patients with a CRP level > 170 mg/L are at higher risk for non-antibiotic treatment failure. Clinical physicians should take this finding in consideration when selecting patients for non-antibiotic treatment.
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Registered trials
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