Small Intestinal Diverticulosis Medication

Updated: Oct 01, 2019
  • Author: Rohan C Clarke, MD; Chief Editor: Burt Cagir, MD, FACS  more...
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Medication Summary

Antibiotics are important in the management of diverticulitis and related complications.



Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the clinical setting. Antibiotic combinations are usually recommended for serious gram-negative bacillary infections. This approach ensures coverage for a broad range of organisms and polymicrobial infections. In addition, it prevents resistance from bacterial subpopulations and provides additive or synergistic effects. Once organisms and sensitivities are known, the use of antibiotic monotherapy is then recommended. Antibiotics can be administered PO in mild disease and unambiguous diagnosis, otherwise administer IV.

Rifaximin (Xifaxan)

Broad spectrum non-absorbable antibiotic used for treatment of small bowel bacterial overgrowth and traveler's diarrhea. Inhibits DNA-dependent RNA polymerase(rifamycin)

Metronidazole (Flagyl)

Active against various anaerobic bacteria and protozoa. Appears to be absorbed into the cells and the intermediate metabolized compounds that are formed, act by binding DNA and inhibiting protein synthesis, which causes cell death.

Clindamycin (Cleocin)

Effective against aerobic and anaerobic streptococci but not enterococci. Inhibits bacterial protein synthesis by inhibiting peptide chain initiation at the bacterial ribosome where it preferentially binds to the 50S ribosomal subunit, causing bacterial growth inhibition.

Ampicillin (Marcillin, Omnipen, Polycillin, Principen, Totacillin)

Interferes with bacterial cell wall synthesis during active multiplication, causing bactericidal activity against susceptible organisms.

Amoxicillin (Trimox, Amoxil, Biomox)

Can be used PO when outpatient treatment is indicated. Interferes with the synthesis of cell wall mucopeptide during active multiplication, resulting in a bactericidal activity against susceptible bacteria.

Ciprofloxacin (Cipro)

Fluoroquinolone with activity against pseudomonads, streptococci, MRSA, Staphylococcus epidermidis, and most gram-negative organisms but no activity against anaerobes. Inhibits bacterial DNA synthesis and, consequently, growth.

Imipenem and cilastin (Primaxin)

Used for treatment of multiple organism infections as in peritonitis when other agents are not appropriate.

Cefoxitin (Mefoxin)

Second-generation cephalosporin indicated for gram-positive cocci and gram-negative rod infections. Infections caused by cephalosporin-resistant or penicillin-resistant gram-negative bacteria may respond to cefoxitin.

Ticarcillin and clavulanate potassium (Timentin)

Inhibits biosynthesis of cell wall mucopeptide and is effective during the stage of active growth. Antipseudomonal penicillin plus beta-lactamase inhibitor that provides coverage against most gram-negative bacteria and most anaerobes.

Ampicillin and sulbactam sodium (Unasyn)

Drug combination antimicrobial agents consisting of a beta-lactamase inhibitor and ampicillin. Active against skin, enteric flora, and anaerobes.