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Acute uncomplicated diverticulitis is treated with bowel rest and antibiotic therapy but there is no controlled trail to support this. The aim of the study was to determine whether antibiotic therapy hastens recovery andprevents surgical complications and recurrence.Aprospective multicentre randomized controlled trial was carried out, involving ten surgical clinics in Sweden and one in Island. Patients with a CT scan which diagnosed acute uncomplicated diverticulitis were randomized to treatment with or without antibiotics. They were followed for one year.Between October 2003 and January 2009, 615 (398 females) patients were included. The groups were comparable regarding age, gender, BMI, fever and WBC. Median age was 58 years (range 23-88) and median hospital stay was three days. Perforation waspresent in seven cases and abscess formation in two. There were no significant differences between the groups for perforation (P = 0.71), abscess formation (P = 0.16) or hospital stay (P = 0.70). Recurrence at one year was the same in both groups (16%), (P = 0.82).Antibiotic therapy does notprevent surgical complications or recurrence and does not shorten hospital stay. Antibiotics should therefore not be used for treatment of acute uncomplicated diverticulitis.