Clinical Question: In adult patients with symptoms of diverticulitis, would IV antibiotics offer a more expedient resolution of symptoms when compared to oral antibiotics?
Background: Diverticulitis is common in the United States with over 100,000 hospitalizations annually, and is most commonly found in the sigmoid and descending aspect of the colon. The most common symptom of diverticulitis is pain in the lower left quadrant and constipation. The exact cause of diverticulitis is unknown; however, it has been suggested that obstruction of diverticula leads to inflammation and bacterial overgrowth. Hinchey’s criteria is used to determine the risk of mortality with 0.9). Secondary endpoints observed were temperature, leukocyte count, CRP, and ESR. Baseline characteristics were similar in both groups. Seventy six patients were needed for the study to be …show more content…
The oral group had a tenderness score of 1.26 and the IV group had a score of 1.20 (P=0.76). No patients in either group progressed to a higher grade of Hinchey (III or IV) during the study. Throughout the study, there were no statistical differences in the groups, and analysis done after the study demonstrated that the oral group was not inferior to the IV group (delta 0.187). In the oral and IV group, there were no treatment failures; however, one patient from each group was readmitted within thirty days of their discharge. Those patients were once again randomized into both of the study groups, their readmission was considered in the analysis, and their cases resolved. Also, patients that had been treated as an outpatient with antibiotics were allowed to be randomized and included in the study. Another consideration was length of hospital stay, and the oral group had a shorter average stay (5.3 days vs 6.6 days) but it was not statistically significant (P=
Background: Diverticulitis is common in the United States with over 100,000 hospitalizations annually, and is most commonly found in the sigmoid and descending aspect of the colon. The most common symptom of diverticulitis is pain in the lower left quadrant and constipation. The exact cause of diverticulitis is unknown; however, it has been suggested that obstruction of diverticula leads to inflammation and bacterial overgrowth. Hinchey’s criteria is used to determine the risk of mortality with 0.9). Secondary endpoints observed were temperature, leukocyte count, CRP, and ESR. Baseline characteristics were similar in both groups. Seventy six patients were needed for the study to be …show more content…
The oral group had a tenderness score of 1.26 and the IV group had a score of 1.20 (P=0.76). No patients in either group progressed to a higher grade of Hinchey (III or IV) during the study. Throughout the study, there were no statistical differences in the groups, and analysis done after the study demonstrated that the oral group was not inferior to the IV group (delta 0.187). In the oral and IV group, there were no treatment failures; however, one patient from each group was readmitted within thirty days of their discharge. Those patients were once again randomized into both of the study groups, their readmission was considered in the analysis, and their cases resolved. Also, patients that had been treated as an outpatient with antibiotics were allowed to be randomized and included in the study. Another consideration was length of hospital stay, and the oral group had a shorter average stay (5.3 days vs 6.6 days) but it was not statistically significant (P=