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Metronidazole, sold under the brand name Flagyl among others, is an antibiotic and antiprotozoal medication. [10] It is used either alone or with other antibiotics to treat pelvic inflammatory disease, endocarditis, and bacterial vaginosis. [10] It is effective for dracunculiasis, giardiasis, trichomoniasis, and amebiasis. [10]
Mesalamine is an anti-inflammatory medication used in the treatment of inflammatory bowel diseases. [68] In limited studies, patients with diverticulitis and symptomatic diverticular disease treated with mesalamine have shown improvement in both conditions. [ 69 ]
Antibiotics should be used selectively in most cases of uncomplicated diverticulitis. However, antibiotic use is strongly advised in immunocompromised patients. [11] Colonoscopy is recommended 6–8 weeks after an episode of complicated diverticulitis or a first-ever episode of diverticulitis.
Antibiotics include ciprofloxacin and metronidazole, given for 14 days. If symptoms recur after improvement with antibiotics, a second course of antibiotics may be given. If an initial course of antibiotics is ineffective, then mesalamine may be tried. If mesalamine is ineffective, then a course of prednisone may be helpful.
Diverticulitis is defined as diverticular disease with signs and symptoms of diverticular inflammation. Clinical features of acute diverticulitis include constant abdominal pain, localized abdominal tenderness in the left lower quadrant of the abdomen, nausea, vomiting, constipation or diarrhea, fever and leukocytosis .
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