Amoxicillin-Clavulanate As Good As Metronidazole Fluoroquino
Outpatient diverticulitis is generally treated with amoxicillin-clavulanate or a combination of metronidazole and a fluoroquinolone (metronidazole-withfluoroquinolone). The FDA suggested to reserve Fluoroquinolones for conditions with no other alternatives.

This sparked Dr. Charles E Gaber and his team to compare the benefits and short comings of metronidazole-fluoroquinolone and Amoxicillin-Clavulanate combination for outpatient diverticulitis. They published the findings in the June 2021 edition of Annals of Internal Medicine that amoxicillin-clavulanate reduces the risk for fluoroquinolone-related harms without adversely affecting outcomes.

This study was based on claims data on U.S. citizens aged 18 to 64 with private employer-sponsored insurance from 2000 to 2018 and those aged 65 and over with Medicare from 2006 to 2015. Immunocompetent adults were grouped randomly into Metronidazole-with-fluoroquinolone group and amoxicillin-clavulanate group.

Major highlights of the study:

• The study evaluated the population for 1-year risks for inpatient admission, urgent surgery, and Clostridioides difficile infection (CDI) and 3-year risk for elective surgery.

• MarketScans and Medicare assisted in identifying new users of the respective drugs. The results showed no statistic difference between the two groups in terms of 1-year risk for admission, urgent surgery and 3-year elective risk for surgery.

• Metronidazole with fluoroquinolone population showed a greater 1-year CDI risk than amoxicillin-clavulanate population.

In conclusion the author points out that treatment of diverticulitis with amoxicillinclavulanate in an outpatient environment can help in minimising the incidence of fluoroquinolone-related side effects without compromising diverticulitis-specific results. Further treatment of outpatient diverticulitis with amoxicillin-clavulanate was shown to be comparably effective as a treatment of metronidazole-withfluoroquinolone for outpatient diverticulitis.

Source:
https://www.acpjournals.org/doi/abs/10.7326/M20-6315
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