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A table summarising the choice of antibiotics for adults with suspected or confirmed acute diverticulitis as recommended by NICE
| Type | Antibiotic Choice | Dosage and Course Length |
|---|---|---|
| Oral Antibiotics | ||
| First-choice | Co-amoxiclav | 500/125 mg three times a day for 5 days |
| Alternatives (if penicillin allergy or co-amoxiclav unsuitable) | Cefalexin (caution in penicillin allergy) with metronidazole | Cefalexin: 500 mg 2-3 times/day (1-1.5 g 3-4 times/day if severe) for 5 days Metronidazole: 400 mg three times a day for 5 days |
| Trimethoprim with metronidazole | Trimethoprim: 200 mg twice a day for 5 days Metronidazole: 400 mg three times a day for 5 days | |
| Ciprofloxacin (only if switching from IV; with specialist advice) with metronidazole | Ciprofloxacin: 500 mg twice a day for 5 days Metronidazole: 400 mg three times a day for 5 days | |
| Intravenous Antibiotics | ||
| First-choice | Co-amoxiclav | 1.2 g three times a day |
| Cefuroxime with metronidazole | Cefuroxime: 750 mg 3-4 times/day (1.5 g 3-4 times/day if severe) Metronidazole: 500 mg three times a day | |
| Amoxicillin with gentamicin and metronidazole | Amoxicillin: 500 mg three times a day (1 g four times a day if severe) Gentamicin: Initially 5 to 7 mg/kg once a day, adjusted based on serum concentration Metronidazole: 500 mg three times a... |
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