A retrospective cohort study across Veterans Affairs (VA) facilities found that antibiotic prescribing rates for outpatient cases of uncomplicated diverticulitis remain above 95%, despite guidelines from 2015 recommending more selective use. The findings suggest interventions are needed to align antibiotic prescribing with current guidelines to reduce harms of unnecessary antibiotic exposure. The study is published in Annals of Internal Medicine.  

Fecal_matter_foreign_body

Source: Y. Rosen, MD

Fragments of pericolonic fecal matter, the result of colonic perforation due to diverticulitis, incite a severe inflammatory reaction with foreign body giant cells and fibrosis.

Researchers from the Minneapolis Veterans Affairs Health Care System aimed to examine how often antibiotics are prescribed for uncomplicated diverticulitis and whether practices have changed since the American Gastroenterological Association, American College of Physicians, and other professional societies recommended more selective use in 2015.

Researchers analyzed more than 33,000 emergency department and urgent care visits at 120 VA facilities between October 2015 and June 2025, using electronic health records and statistical modeling to track prescribing trends. They found that antibiotics were given in 96.6% of visits overall, with little variation year to year, even as clinical guidelines advised that many patients may not benefit from routine use.

The authors conclude that prescribing patterns have not meaningfully aligned with evolving recommendations and suggest that targeted interventions may be needed to reduce unnecessary antibiotic use.

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