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Prescribing antibiotic therapy to patients with acute uncomplicated diverticulitis is based on low-level evidence; two controlled trials demonstrated no improved outcomes with antibiotics (NEJM JW Gen Med Sep 15 2018 and Am J Gastroenterol 2018; 113:1045; Br J Surg 2012; 99:532). Investigators randomized 180 patients who were hospitalized for imaging-confirmed acute uncomplicated diverticulitis (Hinchey classification 1a) to receive antibiotics or placebo for 5 to 7 days. Patients who presented with ≥2 systemic inflammatory response syndrome (SIRS) risk factors, cognitive impairment, or recent use of anti-inflammatory agents (within 7 days) were excluded.
No significant differences were noted between groups in hospital length of stay (≈42 ho…