Improving the Treatment of Acute Uncomplicated Diverticulitis in Routine Care

N/ANot Yet RecruitingNCT07824180

Ente Ospedaliero Cantonale, Bellinzona800 enrolled

Overview

Acute uncomplicated diverticulitis is often treated with antibiotics, although current evidence shows that antibiotics are not always necessary. This study will evaluate whether a more standardized approach to treatment can reduce unnecessary antibiotic use without increasing the risk of treatment failure. The study will compare patients treated before and after the new treatment approach is introduced in participating Swiss hospitals. Information on treatment, hospital admissions, complications and recurrence of diverticulitis will be collected. Patients will be followed for up to 24 months.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

800

Conditions

Diverticulitis

Interventions

standardized treatment algorithm

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 18 years or older * CT-confirmirmed acute uncomplicated diverticulitis of the left colon * Ability to provide informed consent for participants in the prospective phase Exclusion Criteria: * Complicated acute diverticulitis, defined as diverticulitis with abscess, perforation (free air), fistula, or distant free fluid * Diverticulitis of the right or transverse colon -.Alternative diagnosis explaining the participant's symptoms * No possibility of completing the 90-day follow-up * Inability to provide informed consent for the prospective phase

Outcomes

Primary Outcomes

Treatment failure

Treatment failure is defined as a composite outcome including progression to complicated diverticulitis requiring percutaneous abscess drainage or surgery, delayed initiation of antibiotics after initial management without antibiotics, or unplanned hospital admission following initial outpatient treatment.

Time frame: Within 90 days after diagnosis

Secondary Outcomes

Antibiotic use

Proportion of participants receiving antibiotics

Time frame: Within 90 days after diagnosis

Adherence to the standardized treatment approach

Proportion of participants whose management is consistent with the standardized treatment approach.

Time frame: At the initial treatment decision

Outpatient versus inpatient management

Proportion of participants initially managed as outpatients versus inpatients.

Time frame: At the initial treatment decision

Hospital admission

Proportion of participants readmitted to hospital.

Time frame: Within 30 days after diagnosis

Recurrence of diverticulitis

Proportion of participants experiencing recurrence of diverticulitis.

Time frame: Within 24 months after diagnosis