From the Research
Diverticulitis in pediatric patients should be treated with bowel rest, intravenous fluids, and broad-spectrum antibiotics, with non-operative treatment recommended as the initial approach, as supported by the most recent study 1. When diagnosed, treatment typically begins with bowel rest, intravenous fluids, and broad-spectrum antibiotics such as piperacillin-tazobactam (100 mg/kg/dose every 8 hours) or a combination of metronidazole (10 mg/kg/dose every 8 hours) and a third-generation cephalosporin like ceftriaxone (50-75 mg/kg/day). Some key points to consider in the treatment of pediatric diverticulitis include:
- The condition is extremely rare in pediatric patients, with most cases occurring in adolescents or those with underlying connective tissue disorders like Ehlers-Danlos syndrome or Marfan syndrome 2.
- Pediatric diverticulitis often involves the right colon rather than the sigmoid colon and may be congenital rather than acquired.
- A high-fiber diet is recommended after resolution to prevent recurrence, though evidence for this approach in children is limited.
- Any pediatric patient with diverticulitis should undergo evaluation for underlying connective tissue disorders or motility issues that may predispose them to this unusual condition.
- Non-operative treatment has been shown to be effective in most cases, with surgical intervention reserved for complications such as perforation, abscess formation, or obstruction 1.
- The use of oral antibiotics like amoxicillin-clavulanate (45 mg/kg/day divided twice daily) or ciprofloxacin (20-30 mg/kg/day divided twice daily) with metronidazole (30 mg/kg/day divided three times daily) for 7-10 days may be sufficient for mild cases 3.