256 Acute Uncomplicated Diverticulitis: Is Conservative Management Adequate?

Aim NICE advises conservative management for acute uncomplicated diverticulitis in the absence of sepsis (1). This audit assessed adherence to guidelines and effectiveness of treatment through readmission rates within 2 weeks. An educational intervention was developed and audited to improve adherence and raise awareness about adequacy of treatment. Method Retrospective data from 31 patients, aged 18-80 years old, presenting in November-December 2022, with acute diverticulitis was collated and stratified against NICE guidelines. Educational interventions were implemented to raise awareness. This included departmental posters, surgical juniors teaching, and patient information leaflet development. A second retrospective dataset, involving 29 patients June-July 2023, assessed for increased adherence. Readmission data was evaluated to ascertain the adequacy of conservative/ oral antibiotic management over intravenous treatment. Results 16/31 patients in the first cycle were treated according to NICE guidance. 13 were overtreated: 6 received IV antibiotics instead of oral, 7 received oral antibiotics rather than conservative management. 5/31 were readmitted within 2 weeks: 1 managed conservatively (no antibiotics), 3 treated with IV antibiotics (only 1 appropriately). Post-intervention, 7/29 patients were overtreated and none undertreated: 3 received IV antibiotics instead of oral, 4 received oral antibiotics rather than conservative management. There were no readmissions within two weeks. Overall, there was a 17.5% decrease in overtreatment without increased readmissions. Conclusions Educational interventions improved adherence to guidelines. Management without intravenous antibiotics did not increase readmission rates, supporting current guidelines.