A major international study published in the Lancet’s eClinical medical journal has found that antibiotics are prescribed in up to 99% of diverticulitis cases worldwide, despite clinical guidelines recommending more selective use, according to Bowel Research UK.
The study was funded by Bowel Research UK and delivered through the University of Birmingham Centre for Observational and Prospective Studies (BiCOPS).
Diverticulitis is a common complication of diverticular disease, and occurs when small pouches that form in the bowel wall become inflamed or infected when faecal matter is caught in the pouches. Diverticular disease affects approximately half of adults over 50 in the UK, with around one in four developing diverticulitis.
Bowel rest and pain relief is often all that is needed when diagnosed early, and only some cases of diverticulitis should be treated with antibiotics. With more severe cases, however, infection may occur, requiring antibiotic treatment.
Researchers expressed concern that this overuse could accelerate antimicrobial resistance (AMR), increasing the likelihood that patients may require surgical intervention to remove part of the bowel in more severe cases.
Lindsay Easton, Chief Executive of Bowel Research UK, said: “Diverticulitis is a relatively common disease, but many people have never heard of it.
“This landmark study takes us a big step forward in filling the information gap we have with diverticulitis – now we know how the disease is treated globally, we can use this knowledge to push for change so patients across the world receive the best possible treatments.”
The findings also revealed that 70% of hospitalised patients had uncomplicated diverticulitis, suggesting that greater support and guidance for managing the condition at home could reduce unnecessary admissions.
Lead investigator, Dale Vimalachandran, Consultant Colorectal Surgeon and clinical academic at the University of Liverpool said: “This is the first time the treatment of diverticulitis and outcomes of patients has been analysed globally, and the variation we’ve seen is concerning.
“It’s crucial we see improved pathways to limit the use of antibiotics to those cases that can’t be managed in other ways.”