Amoxicillin-clavulanate as good as metronidazole fluoroquinolone combo for Diverticulitis

Outpatient diverticulitis is generally treated with amoxicillin-clavulanate or a combination of metronidazole and a fluoroquinolone (metronidazole-with-fluoroquinolone). The FDA suggested to reserve Fluoroquinolones for conditions with no other alternatives.

This sparked Dr. Charles E Gaber and his team to compare the benefits and short comings of metronidazole-fluoroquinolone and Amoxicillin-Clavulanate combination for outpatient diverticulitis. They published the findings in the June 2021 edition of Annals of Internal Medicine that amoxicillin-clavulanate reduces the risk for fluoroquinolone-related harms without adversely affecting outcomes.

This study was based on claims data on U.S. citizens aged 18 to 64 with private employer-sponsored insurance from 2000 to 2018 and those aged 65 and over with Medicare from 2006 to 2015. Immunocompetent adults were grouped randomly into Metronidazole-with-fluoroquinolone group and amoxicillin-clavulanate group.

Major highlights of the study

• The study evaluated the population for 1-year risks for inpatient admission, urgent surgery, and Clostridioides difficile infection (CDI) and 3-year risk for elective surgery.