Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, AB, Canada.
Am J Surg. 2018 Sep;216(3):604-609. doi: 10.1016/j.amjsurg.2018.01.039. Epub 2018 Feb 2.
Antibiotics use in acute uncomplicated diverticulitis (AUD) remains debated despite recent studies suggesting no difference in outcomes for patients treated without antibiotics.
Systematic review and meta-analysis were performed to determine the role of antibiotics in managing AUD. Literature search was conducted using Medline, EMBASE, Scopus, the Cochrane Library, and Web of Science databases from 1946 to June 2017. Eight studies with 2469 patients were included for review. Overall complication rates were not statistically significant between groups (OR 0.72; CI 0.45 to 1.16; P = 0.18), but antibiotic use was associated with a longer length of stay in hospital. Subgroup analysis revealed no difference in readmission rates, treatment failure rates, progression to complicated diverticulitis, or increased need for elective or emergent surgery between study groups.
Antibiotic use in patients with AUD increases length of hospital stay but is not associated with a reduction in overall or individual complication rates.
尽管最近的研究表明，未经抗生素治疗的患者的治疗结果并无差异，但急性单纯性憩室炎（AUD）的抗生素使用仍存在争议。
系统评价和荟萃分析旨在确定抗生素在治疗 AUD 中的作用。从 1946 年至 2017 年 6 月，使用 Medline、EMBASE、Scopus、Cochrane 图书馆和 Web of Science 数据库进行文献检索。共纳入 8 项研究，共计 2469 例患者。总体并发症发生率在组间无统计学意义（OR 0.72；95%CI 0.45 至 1.16；P=0.18），但抗生素的使用与住院时间延长有关。亚组分析显示，两组间的再入院率、治疗失败率、进展为复杂性憩室炎的比率或择期或急诊手术的需求增加无差异。
在 AUD 患者中使用抗生素会增加住院时间，但与总体或个别并发症发生率的降低无关。
