- Additional Information
- Management of Acute Diverticulitis PICO Table (PDF, 30 KB)
- Describe your topic.
- Management of Acute Diverticulitis. The key questions for this nomination are: Key Question 1: What are the effectiveness/harms and comparative effectiveness/harms of oral or parenteral antibiotics for the treatment of diverticulitis compared to each other and compared to treatment without antibiotics? a. Do the effectiveness/harms vary by route of administration of antibiotic, type of antibiotic, duration of course of antibiotic? b. Do the effectiveness/harms vary by patient characteristics or presentation of illness? Key Question 2: What are the benefits and harms of CT imaging for the initial diagnosis of diverticulitis? a. Do the benefits and harms vary by patient characteristics or presentation of illness? Key Question 3: What are the benefits and harms of distant colonoscopy following an episode of diverticulitis? a. Do the benefits and harms vary by patient characteristics or presentation/course of illness? Key Question 4: What are the benefits and harms of interventional versus surgical management of recurrent diverticulitis? a. Do the benefits and harms vary by patient characteristics or presentation/course of illness? Key Question 5: What are the effectiveness and harms of pharmacological (e.g., mesalamine) and non-pharmacologic (e.g., dietary advice) interventions to prevent recurrent diverticulitis?
- Describe why this topic is important.
- Diverticular disease is common, with the prevalence increasing with age. A systematic evidence review on the management in complicated diverticulitis can help to standardize and optimize care for patients with the condition.
- Tell us why you are suggesting this topic.
- We would like to develop a guideline on this topic.
- Target Date.
- Describe what you are doing currently and what you are hoping will change because of a new evidence report.
- With the increasing use of oral antibiotics with high bioavailability, parenteral antibiotics given as outpatients, and the advances in interventional radiology, this review can help guide clinicians on the most effective, safe site of treatment (inpatient vs. outpatient). In addition, those with complicated acute diverticulitis have variations in care ranging from surgical intervention to IR drainage to medical therapy only. This review can help standardize the care on criteria for outpatient versus inpatient treatment of diverticulitis, criteria for imaging (e.g., CT, colonoscopy) for diagnosis or management of diverticulitis, the optimal choice and duration of antibiotic treatment for diverticulitis criteria for initial interventional radiology vs surgical management in complicated diverticulitis.
- How will you or your group use the information from a new evidence report?
- We would use it to develop a guideline.
- How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?
- We would work with the authors of the evidence report to publish a summary evidence report alongside of our guideline in a peer-reviewed journal. The guideline would also be disseminated via our guidelines app, presentation at our annual internal medicine meeting, and inclusion in guideline databases.
- Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?
- American Academy of Family Physicians frequently endorses our guidelines, and we occasionally partner on developing joint guidelines with them.
- Information About You: (optional)
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- Provide a description of your role or perspective.
- Professional Society (American College of Physicians)
- If you are you making a suggestion on behalf of an organization, please state the name of the organization.
- American College of Physicians
- Please tell us how you heard about the Effective Health Care Program.
- Ongoing relationship
