Ciprofloxacin for Diverticulitis: Does, Side Effects, & Alternatives.

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Ciprofloxacin for diverticulitis, key facts:

Ciprofloxacin is an antibiotic medication that we use to treat bacterial infections. Ciprofloxacin acts by stopping the growth of bacteria.

Here are some critical facts about ciprofloxacin and diverticulitis.

  • Ciprofloxacin is one of the most commonly used antibiotics to treat diverticulitis.
  • It is available in both intravenous and oral forms.
  • Both forms can be used in the treatment of diverticulitis.
  • Ciprofloxacin is not used alone for diverticulitis. Instead, we combine ciprofloxacin with metronidazole (Flagyl) to cover all types of bacteria.
  • The duration of oral ciprofloxacin after discharge or mild cases is often 10 to 16 days.

When to use ciprofloxacin for diverticulitis?

  • Oral ciprofloxacin is given together in patients with mild diverticulitis.
  • Oral ciprofloxacin plus metronidazole is also given after the discharge from the hospital in cases of severe or complicated diverticulitis (also for 10-14days).
  • Intravenous ciprofloxacin is given with metronidazole to treat severe or complicated cases of acute diverticulitis during hospital admission (for low-risk patients), not preferred as empiric treatment for high-risk patients.

Ciprofloxacin doesn’t cover all the spectrum of bacteria. That’s why we use metronidazole which is active against a group of bacteria called (anaerobes).

The use of ciprofloxacin plus metronidazole is a preferred empiric treatment in patients with acute diverticulitis. However, it is not suitable for high-risk people:

  • People who are older than 70.
  • People with recent travel history to areas of the world with high rates of bacterial resistance.
  • Immunosuppressed patients or patients are taking immunosuppressive medications.
  • Patients with significant medical co-morbid diseases.
  • Patients with complicated diverticulitis (diffuse peritonitis, perforation, large abscess).

Typically, those high-risk patients require much more aggressive therapy.

The two tables below illustrate the common empiric antibiotics for low and high-risk patients with diverticulitis.

Table 1 shows the best antibiotic regimens for acute diverticulitis in high-risk patients (reference).

Table 2 shows the best antibiotics for acute diverticulitis in low-risk patients (including ciprofloxacin).