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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. [12]
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.
Treatment may include antibiotics, aminosalicylates, and corticosteroids. 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.
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Ciprofloxacin is a fluoroquinolone antibiotic used to treat a number of bacterial infections. [5] This includes bone and joint infections , intra-abdominal infections, certain types of infectious diarrhea , respiratory tract infections , skin infections, typhoid fever , and urinary tract infections , among others. [ 5 ]
Clarithromycin, sold under the brand name Biaxin among others, is an antibiotic used to treat various bacterial infections. [3] This includes strep throat, pneumonia, skin infections, H. pylori infection, and Lyme disease, among others. [3] Clarithromycin can be taken by mouth as a tablet or liquid or can be infused intravenously. [3]
Other symptoms include pain localized to the urethra or pelvis and frequent urinary tract infection. [3] When urethral diverticulum becomes severe, a painful mass can sometimes be felt inside the introitus of the vagina, which can discharge pus. If the mass is hard or bleeds, complications like cancer or kidney stones may be present. [3]
Clostridioides difficile, also known more commonly as C. diff, accounts for 10 to 20% of antibiotic-associated diarrhea cases, because the antibiotics administered for the treatment of certain disease processes such as inflammatory colitis also inadvertently kill a large portion of the gut flora, the normal flora that is usually present within the bowel.