ACUTE UNCOMPLICATED DIVERTICULITIS: Guidelines on Diagnosis and Management: is everything fine?

The transition from intravenous (IV) antibiotic therapy to oral therapy and the observation that in patients with acute uncomplicated diverticulitis (AUD), treatment with or without antibiotics gave similar results in both hospitalized and outpatients, opened the way for out-of-hospital treatment in selected patients with CT-confirmed diagnosis. Due to economic constraints and a growing demand for hospitalization, home hospital care (HAH) and other community-based services was supported to alleviate the burden on emergency departments (EDs). This resulted in significant cost savings for the National Health Service (NHS) but, in many countries, community services are not uniformly present, leading to health care inequality. Relationships between hospital and community doctors indicate poor professional communication. Shared guidelines could lead to increased adherence. Some conditional recommendations based on low-certainty evidence related to the diagnosis and management of AUD remain controversial. Even after recovery from an episode, the question of whether to pursue conservative management or elective surgery is still open for debate. The outpatient treatment is understood as referring to both patients managed by hospital doctors and those treated by general physicians in their office. On management and outcomes of patients with AUD diagnosis in primary care there is little data. AUD treatment without antibiotics encounters resistance in many countries for multiple reasons, including low implementation and uncertain dissemination of guidelines recommendations. This would require greater control and commitment on the part of Institutional bodies and scientific societies.