Long‐term follow‐up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis

Background The aim of this study was to assess the long‐term results in patients with uncomplicated diverticulitis who had participated in the Antibiotics in Acute Uncomplicated Diverticulitis (AVOD) RCT, which randomized patients with CT‐verified left‐sided acute uncomplicated diverticulitis to management without or with antibiotics. Methods The medical records of patients who had participated in the AVOD trial were reviewed for long‐term results such as recurrences, complications and surgery. Quality‐of‐life questionnaires (EQ‐5D™) were sent to patients, who were also contacted by telephone. Descriptive statistics were used for the analysis of clinical outcomes. Results A total of 556 of the 623 patients (89·2 per cent) were followed up for a median of 11 years. There were no differences between the no‐antibiotic and antibiotic group in recurrences (both 31·3 per cent; P = 0·986), complications (4·4 versus 5·0 per cent; P = 0·737), surgery for diverticulitis (6·2 versus 7·1 per cent; P = 0·719) or colorectal cancer (0·4 versus 2·1 per cent; P = 0·061). The response rate for the EQ‐5D™ was 52·8 versus 45·2 per cent respectively (P = 0·030), and no differences were found between the two groups in any of the measured dimensions. Conclusion Antibiotic avoidance for uncomplicated diverticulitis is safe in the long term. Antecedentes El objetivo de este estudio fue evaluar los resultados a largo plazo con respecto a las recidivas, las complicaciones, la cirugía y la calidad de vida (quality of life, QOL) en pacientes con diverticulitis no complicada que participaron en el ensayo clínico aleatorizado Antibióticos en la Diverticulitis Aguda no Complicada (Antibiotics in Acute Uncomplicated Diverticulitis, AVOD). Métodos Los pacientes con diverticulitis aguda no complicada del lado izquierdo diagnosticada mediante tomografía computarizada se aleatorizaron a los tratamientos sin o con antibióticos en el ensayo AVOD (previamente publicado). Las historias clínicas de los pacientes que participaron en el ensayo se revisaron para conocer resultados a largo plazo, tales como recidivas, complicaciones y cirugía. Se enviaron cuestionarios de calidad de vida (EQ‐5D) a los pacientes a los que también se contactó por teléfono. Resultados Un total de 556 de los 623 pacientes (89,2%) fueron seguidos durante una mediana de 11 años. No hubo diferencias en la recidiva (86 versus 88; P = 0,986), complicaciones (12 versus 14; P = 0,737), cirugía por diverticulitis (17 versus 20; P