General Practitioner, Italian Association for Gastroenterology in Primary Care (GIGA-CP), Feltre (BL), Italy.
Eur Rev Med Pharmacol Sci. 2021 Jan;25(1):423-430. doi: 10.26355/eurrev_202101_24410.
Symptomatic uncomplicated diverticular disease of the colon (SUDD) is generally managed by gastroenterologists rather than General Practitioners (GPs). The aim of this study was to assess the efficacy of the treatment of SUDD with rifaximin, a non-absorbable antibiotic, in a primary care setting by GPs.
This retrospective, observational study investigated the use of rifaximin at a dose of 400 mg b.i.d. for 5, 7 or 10 days monthly, up to 3 months. The symptoms were reported by the patients using a visual analogic scale (VAS) of 0-10.
286 SUDD patients were enrolled (44.4% of men, average age 70.92±10.98). Respectively, 15 (5.2%) patients received the treatment for 5 days, 205 (71.7%) for 7 days and 66 (23.1%) for 10 days. After three months, a significant reduction of VAS score was observed in almost all symptoms assessed: 135 (47.2%) patients reported no abdominal pain (p<0.001) and 23 (8.1%) reported no symptom. Adverse events related to the treatment were recorded in 3 (1.04%) patients, all of them mild and not requiring interruption of the treatment. Acute diverticulitis occurred in 9 (3.1%) patients, but only 2 of them [0.7% (n=2)] underwent surgery due to complicated diverticulitis. Analysis within the different treatment groups (5, 7 and 10 days) shows that rifaximin treatment is effective in reducing the severity of symptoms in almost all groups except for the constipation in the 5-day group.
Rifaximin can be effectively used by GPs in real-life for the management of SUDD.
结肠单纯性复杂性憩室病（SUDD）一般由胃肠病学家而非全科医生（GPs）管理。本研究旨在评估 GPs 在初级保健环境中使用非吸收性抗生素利福昔明治疗 SUDD 的疗效。
这是一项回顾性观察研究，调查了利福昔明（剂量为 400mg，bid，每月使用 5、7 或 10 天，最多使用 3 个月）的使用情况。患者使用视觉模拟量表（VAS）报告症状（0-10 分）。
共纳入 286 例 SUDD 患者（44.4%为男性，平均年龄 70.92±10.98 岁）。分别有 15 例（5.2%）患者接受了 5 天治疗，205 例（71.7%）接受了 7 天治疗，66 例（23.1%）接受了 10 天治疗。三个月后，几乎所有评估的症状的 VAS 评分均显著降低：135 例（47.2%）患者报告无腹痛（p<0.001），23 例（8.1%）患者报告无任何症状。3 例（1.04%）患者记录到与治疗相关的不良事件，均为轻度，无需中断治疗。9 例（3.1%）患者发生急性憩室炎，但仅 2 例[0.7%（n=2）]因复杂性憩室炎而行手术。在不同治疗组（5、7 和 10 天）内进行分析显示，除 5 天组的便秘外，利福昔明治疗几乎可有效减轻所有组的症状严重程度。
在真实世界中，GPs 可有效使用利福昔明治疗 SUDD。
