“The clinical implications of not using antibiotics for an initial episode of uncomplicated diverticulitis are many, and include potentially decreased costs, and a lower risk of the development of antibiotic resistance worldwide,” he said by email.

“Moreover, not using antibiotics routinely for a first episode of uncomplicated diverticulitis would lead to a very important reduction in the incidence of antibiotic-associated diarrhea and Clostridium difficile-associated illnesses,” he noted. “These outcomes would have a major clinical impact.”

Dr. Eamonn Quigley, chief of gastroenterology and hepatology at Houston Methodist Hospital in Texas, observed, “This is one of a number of recent studies that have questioned several of the traditional approaches to the management of diverticulitis.”

“This study now questions one of the remaining pillars of the traditional approach: the fundamental role of antibiotics,” he told Reuters Health by email.

“Their results suggest that antibiotics can be avoided among those with uncomplicated diverticulitis,” he said, emphasizing that “high-quality imaging was essential in making the initial diagnosis,” and both high-risk patients and those who had prior episodes of diverticulitis were excluded.

Dr. Quigley concluded, “These results will be welcomed as a further contribution to reducing antibiotic exposure in the general population.”