Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile. Adress: Escuela de Medicina, Universidad Finis Terrae, Avenida Pedro de Valdivia 1509, Santiago, Chile. Email:
Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile. ORCID: 0000-0001-5027-5721.
Medwave. 2021 Mar 26;21(2):e8140. doi: 10.5867/medwave.2021.02.8140.
Acute diverticulitis is one of the complications of diverticular disease. Nowadays, there is a paradigm shift regarding the use of antibiotics to manage acute uncomplicated diverticulitis in hospitalized patients, with controversial information about it.
A search was done in Epistemonikos, the most comprehensive health-related systematic review database, maintained by screening multiple information sources including MEDLINE/PubMed, EMBASE, Cochrane, among others. Data were extracted from the identified systematic reviews, data from primary studies were analyzed, which in this work considered only randomized clinical trials, a meta-analysis was done, and a summary table of results was created using GRADE methodology.
Eleven systematic reviews were identified that included seven primary studies in total, of which two were randomized control trials. We concluded that the use of antibiotics in acute uncomplicated diverticulitis could slightly increase complications and result in a minor or no difference in the risk of recurrence and need for urgent surgery. However, the certainty of the evidence is low. Regarding hospital stay and readmission, it was not possible to evaluate the effect due to a low certainty of evidence.
急性憩室炎是憩室病的并发症之一。如今，针对住院患者中急性单纯性憩室炎使用抗生素的治疗方法发生了范式转变，关于这一方法的信息存在争议。
在 Epistemonikos 中进行了检索，该数据库是最全面的与健康相关的系统评价数据库，通过筛选包括 MEDLINE/PubMed、EMBASE、Cochrane 在内的多个信息源进行维护。从确定的系统评价中提取数据，并对原始研究的数据进行分析，在这项工作中仅考虑了随机临床试验，对结果进行了荟萃分析，并使用 GRADE 方法创建了结果汇总表。
共确定了 11 篇系统评价，其中总共包含 7 项原始研究，其中 2 项为随机对照试验。我们的结论是，在急性单纯性憩室炎中使用抗生素可能会略微增加并发症的发生，并且在复发风险和紧急手术需求方面几乎没有差异或差异较小。但是，证据的确定性较低。关于住院时间和再入院，由于证据的确定性较低，无法评估其效果。
