WTP4.02 Use of Antibiotics in Diverticular disease – A double edged sword

Aims This study was conducted to look for adherence to WSES guidelines for the management of diverticular disease. The primary objective was to refine the diagnostic accuracy, particularly focusing on antibiotics protocol/admission policy. We aimed to assess the compliance with use of antibiotics at our local institute. Methods This closed loop audit was conducted at a UK district general hospital from Jan-May 2024 and June-October 2024 including 65 and 52 patients respectively. Data was extracted from electronic database and variables studied were patient demographics, grades of disease, MDT involvement, use of antibiotics, investigation modalities and treatment outcomes. Results The first cycle showed 88% of the patients had a CT scan on admission within the first 24 hours. 29% of the patients were diagnosed having complicated diverticular disease while antibiotics were administered in 88% of the patients indicating injudicious use particularly in uncomplicated disease. No patient benefitted from interventional radiology. These results led to recommendations about use of antibiotics and the start of the 2nd cycle to look for improvement in antibiotics delivery. The second cycle showed waiting time for CT scan and use of antibiotics became more prudent particularly in systemically well patients with uncomplicated disease. Local guidelines were established to improve service delivery. Conclusion Acute diverticulitis is a common problem encountered by Western surgeons. Our study emphasizes the need for the judicious use of antibiotics/admission criteria in uncomplicated diverticulitis patients to standardize the variability in patient care and enhance treatment outcomes by shortening the length of stay.