… is it terrorism? …a nuclear disaster? …a financial crash? …a foreign power? …NO …it is Antibiotic Resistance

Antibiotic Resistance

By Dr Grahame Ctercteko – M.D. (Syd), FRACS

The Specialist Colorectal Group at Lakeview Private Hospital have started a Randomised Clinical Trial (RCT) to study the need (or not) for antibiotics in the management of uncomplicated diverticulitis. This is a double blinded RCT administered through our affiliations with Westmead Hospital and Sydney University and in conjunction with Auckland University Hospital, New Zealand.

At first glance this might sound unwise as it certainly challenges what we all believe to be best practice for diverticulitis until now. A couple of European studies including two RCT (non-blinded) have demonstrated successful management of uncomplicated diverticulitis without antibiotics. This might mean that diverticulitis does not start as an infection but as a mucosal inflammation and only when the mucosal barrier is breeched that infection occurs and antibiotics are needed.

At present antibiotic usage for diverticulitis is extensive. Any chance of eliminating unnecessary antibiotic usage would help reduce antibiotic resistance. I would expect that many of you will have patients in this trial. The easiest way to sort any issues arising from this trial would be through our shared office at Lakeview Private Hospital.