Your browser doesn't support javascript.
loading
Efficacy of antimicrobial therapy in patients with uncomplicated acute colonic diverticulitis: an updated systematic review and meta-analysis.
Seta, Takeshi; Iwagami, Hiroyoshi; Agatsuma, Nobukazu; Noma, Atsushi; Ikenouchi, Maiko; Kubo, Kenji; Akamatsu, Takuji; Uenoyama, Yoshito; Ito, Daisuke; Yamashita, Yukitaka; Nakayama, Takeo.
Afiliação
  • Seta T; Departments of Gastroenterology.
  • Iwagami H; Hepatology and Digestive Cancer Center, Japanese Red Cross Wakayama Medical Center, Wakayama.
  • Agatsuma N; Department of Health Informatics, Graduate School of Medicine & School of Public Health, Kyoto University.
  • Noma A; Departments of Gastroenterology.
  • Ikenouchi M; Hepatology and Digestive Cancer Center, Japanese Red Cross Wakayama Medical Center, Wakayama.
  • Kubo K; Departments of Gastroenterology.
  • Akamatsu T; Hepatology, Kyoto University Graduate School of Medicine Faculty of Medicine, Kyoto.
  • Uenoyama Y; Department of Gastroenterological Surgery and Digestive Cancer Center, Japanese Red Cross Wakayama Medical Center, Wakayama.
  • Ito D; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo Medical University, Hyogo.
  • Yamashita Y; Department of Infectious Diseases and Emergency Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
  • Nakayama T; Departments of Gastroenterology.
Eur J Gastroenterol Hepatol ; 35(10): 1097-1106, 2023 10 01.
Article em En | MEDLINE | ID: mdl-37577799
ABSTRACT
The need for antimicrobial therapy for uncomplicated acute diverticulitis of the colon remains controversial. We conducted a systematic review of the efficacy of antimicrobial agents against this disease, including new randomized controlled trials (RCTs) reported in recent years, and evaluated their efficacy using a meta-analytic approach. RCTs were searched using PubMed, EMBASE, Google Scholar, Cochrane Library, Ichushi-Web, and eight registries. Keywords were 'colonic diverticulitis', 'diverticulitis', 'antimicrobial agents', ''antibiotics, 'complication', 'abscess', 'gastrointestinal perforation', 'gastrointestinal obstruction', 'diverticular hemorrhage', and 'fistula'. Studies with antimicrobial treatment in the intervention group and placebo or no treatment in the control group were selected by multiple reviewers using uniform inclusion criteria, and data were extracted. Prevention of any complication was assessed as the primary outcome, and efficacy was expressed as risk ratio (RR) and risk difference (RD). A meta-analysis was performed using 5 RCTs of the 21 studies that were eligible for scrutiny in the initial search and which qualified for final inclusion. Three of these studies were not included in the previous meta-analysis. Subjects included 1039 in the intervention group and 1040 in the control group. Pooled RR = 0.86 (95% confidence interval, 0.58-1.28) and pooled RD = -0.01 (-0.03 to 0.01) for the effect of antimicrobial agents in reducing any complications. Recurrences, readmissions, and surgical interventions did not significantly show the efficacies of using antimicrobial agents. A meta-analysis of recently reported RCTs did not provide evidence that antimicrobial therapy improves clinical outcomes in uncomplicated acute diverticulitis of the colon.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Diverticulite / Doença Diverticular do Colo / Anti-Infecciosos Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Diverticulite / Doença Diverticular do Colo / Anti-Infecciosos Idioma: En Ano de publicação: 2023 Tipo de documento: Article