From the Research
Ceftin (cefuroxime) is not typically recommended as a first-line treatment for diverticulitis. The most recent and highest quality study, a systematic review published in 2022 1, suggests that the effect of antibiotics, including cefuroxime, is uncertain for complications, emergency surgery, recurrence, elective colonic resections, and long-term complications in uncomplicated acute diverticulitis. For uncomplicated diverticulitis, the preferred antibiotic regimens usually include combinations like ciprofloxacin plus metronidazole, or amoxicillin-clavulanate alone, as supported by a study published in 2021 2. Cefuroxime has limited anaerobic coverage, which is important for diverticulitis treatment since the infection often involves anaerobic bacteria from the colon. While cefuroxime has activity against some gram-negative and gram-positive bacteria, its insufficient coverage of the anaerobic organisms commonly found in diverticular infections makes it suboptimal when used alone. If a physician does prescribe cefuroxime for diverticulitis, it would likely be in combination with an antibiotic that has strong anaerobic coverage, such as metronidazole. Patients with diverticulitis should also follow a clear liquid diet during acute flares, gradually advancing to a low-fiber diet as symptoms improve, and eventually transitioning to a high-fiber diet once the acute episode has resolved.
Some key points to consider when treating diverticulitis include:
- The use of antibiotics in uncomplicated diverticulitis is questionable, as the condition may be inflammatory rather than infectious, as suggested by a study published in 2019 3.
- Outpatient treatment with oral antibiotics, such as amoxicillin-clavulanate, can be effective for uncomplicated diverticulitis, as shown in a study published in 2010 4.
- The choice of antibiotic should be based on the severity of the disease and the presence of complications, with more severe cases requiring intravenous antibiotics, as recommended by a study published in 2021 2.
- The potential risks and benefits of antibiotic treatment, including the risk of Clostridioides difficile infection, should be carefully considered, as highlighted in a study published in 2021 2.
Overall, the treatment of diverticulitis should be individualized based on the severity of the disease, the presence of complications, and the patient's overall health status, with a focus on minimizing morbidity, mortality, and improving quality of life.