Scarpa Cosimo Riccardo, Buchs Nicolas Christian, Poncet Antoine, Konrad-Mugnier Béatrice, Gervaz Pascal, Morel Philippe, Ris Frédéric
Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospital of Geneva, Geneva, Switzerland.
Clinical Epidemiology, University Hospital of Geneva, Geneva, Switzerland.
Ann Coloproctol. 2015 Apr;31(2):52-6. doi: 10.3393/ac.2015.31.2.52. Epub 2015 Apr 30.
This study included all patients treated at the University Hospital of Geneva for a first episode of uncomplicated diverticulitis. Risks of recurrence and treatment failure were evaluated by comparing the results between short-course and long-course intravenous (IV) antibiotic therapy groups.
The records of all patients hospitalized at our facility from January 2007 to February 2012 for a first episode of uncomplicated diverticulitis (Hinchey Ia), as confirmed by computed tomography, were prospectively collected. We published an auxiliary analysis from this registered study at Clinicaltrials.gov (identifier number: NCT01015378). Two groups of patients were considered: one received a short-course IV antibiotic arm (ceftriaxone and metronidazole) for up to 5 days (followed by 5 days of oral antibiotics); the other received a long-course IV arm between days 5 and 10. The primary outcome was the recurrence-free survival time.
Follow-up was completed for 256 patients-50% men and 50% women, with a median age of 56 years (range, 24-85 years). The average follow-up was 50 months (range, 19-89 months). Of the 256 patients included in the study, 46 patients received a short-course IV antibiotic treatment and 210 received a long-course treatment. The recurrence-free survivals were very similar between the two groups, which was supported by a log rank test (P = 0.772). Four treatment failures, all in the long-course IV antibiotic treatment group, occurred.
Treatment of diverticulitis with a short IV antibiotic treatment is possible and does not modify the recurrence rate in patients with uncomplicated diverticulitis.
本研究纳入了在日内瓦大学医院接受首次非复杂性憩室炎治疗的所有患者。通过比较短疗程和长疗程静脉注射（IV）抗生素治疗组的结果，评估复发风险和治疗失败风险。
前瞻性收集了2007年1月至2012年2月期间在我们医院因首次非复杂性憩室炎（经计算机断层扫描确诊为Hinchey Ia级）住院的所有患者的记录。我们在Clinicaltrials.gov上发表了这项注册研究的辅助分析（标识符编号：NCT01015378）。将患者分为两组：一组接受短疗程静脉注射抗生素治疗（头孢曲松和甲硝唑），为期5天（随后口服抗生素5天）；另一组在第5至10天接受长疗程静脉注射治疗。主要结局是无复发生存时间。
对256例患者完成了随访，其中男性和女性各占50%，中位年龄为56岁（范围24 - 85岁）。平均随访时间为50个月（范围19 - 89个月）。在纳入研究的256例患者中，46例接受了短疗程静脉注射抗生素治疗，210例接受了长疗程治疗。两组的无复发生存情况非常相似，对数秩检验支持这一结果（P = 0.772）。发生了4例治疗失败，均在长疗程静脉注射抗生素治疗组。
对于非复杂性憩室炎患者，采用短疗程静脉注射抗生素治疗是可行的，且不会改变复发率。
