Are there effective medical treatments to prevent recurrent episodes of acute diverticulitis?

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Abstract

EVIDENCE-BASED ANSWER

Currently, evidence is insufficient to recommend an ideal therapy. In patients with 1 episode of diverticulitis, cyclic therapy with rifaximin and fiber results in an absolute 1.9% decrease in 1-year recurrence of diverticulitis compared with fiber alone (SOR: B, meta-analysis of RCTs). In patients with 2 episodes, cyclic therapy with mesalazine and rifaximin leads to an absolute 15.2% reduction in recurrence of diverticulitis over 1 year compared with rifaximin alone (SOR: B, single RCTs). Mesalazine plus probiotics combined are more effective than probiotics alone (SOR: C, unblinded RCT). Prophylactic therapy with mesalazine alone and antibiotic treatment of initial acute diverticulitis do not alter recurrence rates (SOR: B, single RCTs).

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