Department of Surgery, Center for Minimally Invasive Surgery, Vivantes Hospital Spandau, Neue Bergstrasse 6, 13585 Berlin, Germany.
Int J Colorectal Dis. 2010 Jun;25(6):751-9. doi: 10.1007/s00384-010-0899-4. Epub 2010 Feb 6.
To date, the standard therapy used for acute episodes of uncomplicated sigmoid diverticulitis has been a 7-10-day antibiotic treatment regimen. Thanks to the development of highly potent, broad-spectrum antibiotics such as ertapenem, the question arises as to whether the duration of treatment of acute uncomplicated sigmoid diverticulitis can be reduced by using highly effective antibiotics.
To compare the efficacy of short-term therapy (4 days) versus standard therapy (7 days) for uncomplicated sigmoid diverticulitis, a prospective randomized multicenter trial was conducted. Patients were randomized to treatment groups after 4 days. Both patient groups were monitored until discharge and were followed up after 4-6 weeks and 52 weeks. [corrected] The results were standardized and statistically evaluated.
Between 16 December 2004 and 15 November 2007, 123 patients from 11 hospitals were enrolled in the study. Seventeen patients dropped out. In the remaining 106 cases, no significant differences were discerned between the two groups in terms of the basic data, apart from the mean number of diverticulitis episodes (short term 1.28 +/- 0.64 versus standard 1.64 +/- 1.07, p = 0.037). The mean hospital stay was 8.8 days, with significant differences seen between short-term and standard therapy (7.8 +/- 2.8 versus 9.7 +/- 3.2 days; p = 0.002). After 4 days, treatment was classified as having proved successful in 98.0% of cases and after 7 days in 98.2% of cases. An overall success rate of 95.1% (94.0% versus 96.2%, n.s.) was recorded after 1 month.
The results obtained with short-term ertapenem therapy (4 days) showed that this was as effective as standard therapy (7 days) for treatment of uncomplicated sigmoid diverticulitis.
迄今为止，治疗单纯性乙状结肠憩室炎急性发作的标准疗法是使用 7-10 天的抗生素治疗方案。由于出现了强力广谱抗生素如厄他培南，人们开始怀疑是否可以通过使用高效抗生素来缩短单纯性乙状结肠憩室炎的治疗时间。
为了比较短期（4 天）与标准（7 天）治疗单纯性乙状结肠憩室炎的疗效，进行了一项前瞻性随机多中心试验。在 4 天后，患者被随机分配到治疗组。两组患者均进行监测直至出院，并在 4-6 周和 52 周后进行随访。[更正]结果进行了标准化和统计学评估。
2004 年 12 月 16 日至 2007 年 11 月 15 日，11 家医院的 123 名患者入组研究。17 名患者退出。在剩余的 106 例患者中，两组在基本数据方面除了憩室炎发作次数的平均值（短期组 1.28 +/- 0.64 与标准组 1.64 +/- 1.07，p = 0.037）外，没有显著差异。平均住院时间为 8.8 天，短期和标准治疗之间有显著差异（7.8 +/- 2.8 与 9.7 +/- 3.2 天；p = 0.002）。在第 4 天，98.0%的病例治疗被分类为成功，第 7 天为 98.2%。1 个月后，总体成功率为 95.1%（94.0%与 96.2%，无统计学差异）。
短期厄他培南治疗（4 天）的结果表明，这种方法与标准治疗（7 天）一样有效，可用于治疗单纯性乙状结肠憩室炎。
