Diverticulitis

Diagnosis Common Pathogens Drug(s) of First Choice Alternative Drug(s) Comments Expected Duration

Diverticulitis

For severe infection, refer to severe secondary peritonitis

E. coli

Klebsiella

B. fragilis

Streptococci spp

Inpatient: Ceftriaxone PLUS Metronidazole

Outpatient: Amoxicillin/clavulanic acid 875/125 mg po TID 

OR 

Ciprofloxacin PLUS Metronidazole

For severe beta-lactam allergy:

Inpatient: Vancomycin

PLUS

Aztreonam

PLUS

Metronidazole

Outpatient:

Ciprofloxacin

PLUS

Metronidazole
Management without antibiotics can be considered in patients with uncomplicated disease (no signs of severe infection, no evidence of fistula or abscess, not immunosuppressed) 10 days (can step down to oral therapy to complete course)