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Oral antibiotics for acute colonic diverticulitis in adults

Oral antibiotics for acute colonic diverticulitis in adults
Amoxicillin-clavulanate (1 tablet [contains 875 mg amoxicillin and 125 mg clavulanic acid] every 8 hours) or amoxicillin-clavulanate extended-release (2 tablets [each tablet contains 1 g amoxicillin and 62.5 mg clavulanic acid] every 12 hours)
Ciprofloxacin (500 mg every 12 hours) plus metronidazole (500 mg every 8 hours)
Levofloxacin (750 mg once daily) plus metronidazole (500 mg every 8 hours)
Trimethoprim-sulfamethoxazole (1 double-strength tablet every 12 hours) plus metronidazole (500 mg every 8 hours)
  • The local antibiogram should be consulted to avoid prescribing a regimen to which bacterial resistance exceeds 10%.
  • Doses may need to be adjusted for kidney impairment or other factors; refer to drug monographs included within UpToDate for additional details.
  • Most immunocompetent patients should complete a course of 4 to 7 days (inclusive of both intravenous and oral antibiotics), except for those with an undrained abscess or phlegmon, who should receive 7 to 10 days of antibiotics. Immunocompromised patients should be treated with antibiotics for 10 to 14 days. The duration of antibiotic therapy should be tailored to individual patients based on their clinical response and whether source control has been achieved.
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