ReviewCureus2025
Need for Antibiotics in Cases of Acute Uncomplicated Diverticulitis: A Meta-Analysis of Conservative Versus Antibiotic Treatment Approaches.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute uncomplicated diverticulitis (AUD) is often treated with antibiotics, though recent evidence questions their necessity in clinically stable patients. Concerns over antibiotic resistance have prompted consideration of conservative, non-antibiotic management, but clinical equivalence remains debated. This study aimed to compare antibiotic versus non-antibiotic management for CT (computed tomography)-confirmed AUD in adults, focusing on outcomes like mortality, complications, recurrence, surgery, and length of hospital stay (LOS). A systematic search (2016-2025) was carried out across five databases, identifying randomized controlled trials (RCTs) comparing antibiotic to conservative treatment in patients with Hinchey 1a/1b or Modified Neff grade 0 diverticulitis. Two reviewers independently extracted data and assessed bias using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcomes were analyzed using a DerSimonian-Laird random-effects model. Seven RCTs (n = 8,035) met inclusion criteria. No significant differences were found in mortality (odds ratio (OR) 1.06; 95% CI: 0.71-1.58), complications (OR 0.67; 95% CI: 0.27-1.67), emergency surgery (OR 0.60; 95% CI: 0.23-1.54), or recurrence (OR 0.96; 95% CI: 0.65-1.44). LOS was marginally shorter in the conservative group. Heterogeneity for mortality and LOS was moderate (I² = 43.2%). Most studies defined clinical stability based on the absence of systemic signs and CT-confirmed localized inflammation; some variations in diagnostic criteria were noted. Conservative treatment without antibiotics in select AUD patients yields comparable outcomes to antibiotic use. These findings support guideline recommendations favoring selective antibiotic use, though heterogeneity in population definitions and short follow-up in some studies should be noted.
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Registered trials
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