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ABD 5 Diverticulitis

Content version
U-267.2
Updated
10/20/2025 - 13:17

Recommendations

≥ 18 years

Indications: Complicated diverticulitis
Dosage Remarks
piperacillin/tazobactam IV continuous over 24 hours

or

piperacillin/tazobactam IV 4500 mg 4 times daily

Dosing for continuous infusion:

Initially load with 4000/500 mg over 30 minutes, then 16000/2000 mg continuously over 24 hours.
≥ 18 years

Contraindications: Allergy to penicillins*
Dosage Remarks
cefuroxime IV 1500 mg 3 times daily

+

metronidazole PO 500 mg 3 times daily

+

amikacin IV 20 mg/kg once

non–IgE-mediated penicillin allergy

amikacin only in case of sepsis

Comments

*See protocol Policy for antibiotic allergy | Radboud UMC

Do not routinely treat patients with uncomplicated acute diverticulitis (Hinchey 1) with antibiotics.

Duration depends on the clinical situation. There is evidence that 4 days of antibiotic treatment after achieving source control is sufficient (Sawyer et al. NEJM 2015).

Amikacin in case of sepsis until culture results are known.