背景：
急性憩室炎发生在25％患有憩室病的个体中，并且与显着的发病率和死亡率相关。疾病严重程度被分类为简单或复杂，后者包括穿孔，瘘管，阻塞或远处脓肿。无需手术或侵入性治疗，无复杂的憩室炎通常会得到改善。抗生素的给药是治疗急性单纯性憩室炎的标准治疗方法。然而，最近的数据表明抗生素不会显着影响结果。为了解决这些相互矛盾的方法，外科感染学会在其第37届年会上主办了一次更新研讨会，探讨了抗生素在治疗急性单纯性憩室炎中的作用。在这里，我们提供研讨会的发现概要和对该主题的近期前瞻性和随机临床试验的简要回顾。

方法：
对2010年1月1日至2018年1月1日发表的前瞻性系列和随机临床试验进行了Embase，MEDLINE和Cochrane图书馆的检索，比较了抗生素与非抗生素治疗急性单纯性憩室炎的结果。

结果：
我们确定了两个单中心前瞻性系列和两个随机临床试验，比较了用抗生素治疗的急性单纯性憩室炎患者与无抗生素治疗患者的预后。

结论：
目前的证据不支持使用抗生素来改善精心挑选的急性无并发症左侧憩室炎患者的预后。进一步的研究应该有助于确定从抗生素治疗中获益的患者的特定亚群，并帮助确定适当的抗生素治疗方案和治疗持续时间，以最大限度地降低成本，不良反应和抗微生物药物耐药性的风险。

BACKGROUND:
Acute diverticulitis occurs in 25% of individuals with diverticular disease and is associated with significant morbidity and mortality rates. Disease severity is classified as uncomplicated or complicated, with the latter including perforation, fistula, obstruction, or distant abscess. Uncomplicated diverticulitis often improves without surgery or invasive therapies. Administration of antibiotics is a standard of care for treatment of acute uncomplicated diverticulitis. However, recent data suggest antibiotics do not influence outcomes significantly. To address these conflicting approaches, the Surgical Infection Society hosted an Update Symposium at its 37th Annual Meeting examining the role of antibiotics in the treatment of acute uncomplicated diverticulitis. Here, we provide a synopsis of the symposium's findings and a brief review of recent prospective and randomized clinical trials on the topic.

METHODS:
A search of Embase, MEDLINE, and the Cochrane Library was performed for prospective series and randomized clinical trials published between January 1, 2010, and January 1, 2018, comparing outcomes of antibiotic versus no antibiotic therapy for acute uncomplicated diverticulitis.

RESULTS:
We identified two single-center prospective series and two randomized clinical trials comparing outcomes for patients with acute uncomplicated diverticulitis treated with antibiotics versus no antibiotics.

CONCLUSION:
Current evidence does not support administration of antibiotics to improve outcomes in carefully selected healthy patients with acute uncomplicated left-sided diverticulitis. Further studies should help identify specific subpopulations of patients who would derive benefit from antibiotic therapy and help define appropriate antibiotic regimens and treatment durations that minimize cost, adverse effects, and risk of anti-microbial resistance.

https://www.ncbi.nlm.nih.gov/pubmed/30204549