Year 2018 Vol. 26 No 4

GENERAL & SPECIAL SURGERY

M.A. VOYNOV, B.V. MAGNAEV, A.R. ZOTOVA

EFFICIENCY AND EXPEDIENCE OF ANTIBIOTIC TREATMENT FOR COLONIC DIVERTICULITIS

I.M. Sechenov First Moscow State Medical University, Moscow,
The Russian Federation

Objective. To study the efficacy and to establish expedience of antibiotic treatment for diverticulitis.
Methods. The retrospective analysis of 141 medical histories was made of patients with acute uncomplicated diverticulitis, who were treated during the period from 2013 to 2016 years. Antibiotics were prescribed to treat 85 (60.3%) patients (the main group), 56 (39.7%) patients (the control group) were not given antibacterial drugs. To assess the treatment effectiveness, a dynamic assessment of the clinical picture and laboratory indicators was performed. In the long-term period, patients were questioned to determine the nature of the course and the occurrence of relapses of diverticulitis.
Results. The duration of hospitalization of the main group patients was 10.83.2 days (Mσ), control - 11.22.6 days (Mσ), p>0.05. During the treatment, disease progression was registered in none of the patients. In the main group the body temperature was normalized after 1.6 0.4 days, in the control group after 1.70.3 days, p>0.05. The level of leukocytes came back to normal in the main group at 2.70.8 days, in the control group at 2.90.7 days (p>0.05).
Long-term results were evaluated in 82 (96.5%) of patients and 55 (98.2%) in the control group. Use of antibiotic treatment in diverticulitis had no effect in the remote period for redevelopment of complications (OR 1.19; CI 0.58-2.44), the need to seek medical care (OR 1.11; CI 0.52-2.34), need for hospitalization (OR 0.95, CI 0.3-2.96) and surgical treatment (OR 1.36, CI 0.34-7.69).
Conclusions. The use of antibiotic treatment for diverticulitis does not affect the outcome of treatment and does not determine the further course of the disease. Taking into account the increasing resistance of microorganisms to antibiotics and the need to optimize costs with limited funding for health care, it is advisable to exclude the use of antibacterial drugs for the treatment of uncomplicated diverticulitis.

Keywords: acute uncomplicated diverticulitis, anti-bacterial agents, complications, diverticulitis, treatment of diverticulitis, antibiotic-free treatment
p. 440-446 of the original issue
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Address for correspondence:
19027, The Russian Federation,
Moscow, Yauzskaya Str., 11/6, b. 1.,
I.M. Sechenov First Moscow
State Medical University,
Department of General Surgery,
Tel.: +7-967-139-36-96,
e-mail: info@doctorvoinov.ru,
Mikhail A. Voinov
Information about the authors:
Voinov Mikhail A., PhD, Assistant of the Department of General Surgery, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
http://orcid.org/0000-0001-9857-9249
Magnaev Badma V., Clinical Intern of the Department of General Surgery, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
http://orcid.org/0000-0002-7426-7563
Zotova Anna R., Student of the Medical Faculty, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
http://orcid.org/0000-0003-4891-279
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