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Long‐term follow‐up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis.

Published: 6th August 2019

Authors: D. Isacson, K. Smedh, M. Nikberg, A. Chabok

Background

The aim of this study was to assess the long‐term results in patients with uncomplicated diverticulitis who had participated in the Antibiotics in Acute Uncomplicated Diverticulitis (AVOD) RCT, which randomized patients with CT‐verified left‐sided acute uncomplicated diverticulitis to management without or with antibiotics.

Method

The medical records of patients who had participated in the AVOD trial were reviewed for long‐term results such as recurrences, complications and surgery. Quality‐of‐life questionnaires (EQ‐5D™) were sent to patients, who were also contacted by telephone. Descriptive statistics were used for the analysis of clinical outcomes.

Results

A total of 556 of the 623 patients (89·2 per cent) were followed up for a median of 11 years. There were no differences between the no‐antibiotic and antibiotic group in recurrences (both 31·3 per cent; P = 0·986), complications (4·4 versus 5·0 per cent; P = 0·737), surgery for diverticulitis (6·2 versus 7·1 per cent; P = 0·719) or colorectal cancer (0·4 versus 2·1 per cent; P = 0·061). The response rate for the EQ‐5D™ was 52·8 versus 45·2 per cent respectively (P = 0·030), and no differences were found between the two groups in any of the measured dimensions.

Conclusion

Antibiotic avoidance for uncomplicated diverticulitis is safe in the long term.

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