CURRENT EVIDENCE ON THE USE OF ANTIBIOTICS AND CONSERVATIVE APPROACHES IN THE TREATMENT OF UNCOMPLICATED DIVERTICULITIS

• DOI: https://doi.org/10.22533/at.ed.159542514014

• Palavras-chave: Uncomplicated acute diverticulitis, conservative treatment, antibiotics, efficacy and safety, outpatient management.

• Keywords: Uncomplicated acute diverticulitis, conservative treatment, antibiotics, efficacy and safety, outpatient management.

• Abstract:

  Objective: To evaluate the efficacy and safety of treating acute uncomplicated diverticulitis (AND) without the use of antibiotics, compared with traditional approaches that include antibiotic therapy, and to identify factors that influence clinical outcomes. Methodology: A literature review was carried out following the PVO (Population, Variables and Outcome) strategy. The searches took place in the PubMed database, using specific terms combined with Boolean operators AND, OR and NOT. We included 12 articles published between 2020 and 2024, in Portuguese, English and Spanish, covering reviews, meta-analyses, observational and experimental studies. Duplicate studies, abstracts and those out of scope were excluded. Discussion: Treatment of uncomplicated diverticulitis without antibiotics has been shown to be safe and effective, with complication and recurrence rates similar to those of antibiotic use. The conservative approach reduced hospitalization time, hospital costs and the risk of bacterial resistance. Studies suggest that stable patients, without signs of sepsis and peritonitis, can be safely treated on an outpatient basis. Final considerations: Despite the promising results, there are important methodological limitations, such as the predominance of observational studies, small samples and the absence of standardized criteria for diagnosis and follow-up. The gradual implementation of conservative strategies is recommended, with more robust, multicenter clinical trials aimed at consolidating clear and effective protocols. The approach should be individualized, considering risk factors, clinical characteristics and practical adherence to the guidelines.