Improving the Treatment of Acute Uncomplicated Diverticulitis in Routine Care (AUD)
From Guidelines to Real-world Practice: a Pragmatic Before and After Study on the Treatment of Acute Uncomplicated Diverticulitis (AUD) Based on a Risk Factor Driven Treatment Algorithm (AUD Management Algorithm Protocol)
Acute uncomplicated diverticulitis is often treated with antibiotics, although current evidence shows that antibiotics are not always necessary. This study will evaluate whether a more standardized approach to treatment can reduce unnecessary antibiotic use without increasing the risk of treatment failure.
The study will compare patients treated before and after the new treatment approach is introduced in participating Swiss hospitals. Information on treatment, hospital admissions, complications and recurrence of diverticulitis will be collected. Patients will be followed for up to 24 months.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Dimitri Christoforidis, MD
- E-mail: Dimitrios.Christoforidis@eoc.ch
Undersøgelse Kontakt Backup
- Navn: Elena Porro, Msc
- Telefonnummer: 0041918117038
- E-mail: ricerca.chirurgiaorl@eoc.ch
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Age 18 years or older
- CT-confirmirmed acute uncomplicated diverticulitis of the left colon
- Ability to provide informed consent for participants in the prospective phase
Exclusion Criteria:
- Complicated acute diverticulitis, defined as diverticulitis with abscess, perforation (free air), fistula, or distant free fluid
Diverticulitis of the right or transverse colon
-.Alternative diagnosis explaining the participant's symptoms
- No possibility of completing the 90-day follow-up
- Inability to provide informed consent for the prospective phase
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Ikke-randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Andet: Antibiotic Treatment
Participants with acute uncomplicated diverticulitis who receive antibiotic treatment according to the standardized treatment approach.
|
A standardized treatment approach based on clinical findings, laboratory results, comorbidities, immunosuppression status, and CT findings is introduced to support treatment decisions in patients with acute uncomplicated diverticulitis.
Depending on these factors, patients may be managed with or without antibiotics.
|
|
Andet: No Antibiotic Treatment Arm Description:
Participants with acute uncomplicated diverticulitis who are managed without antibiotics according to the standardized treatment approach.
|
A standardized treatment approach based on clinical findings, laboratory results, comorbidities, immunosuppression status, and CT findings is introduced to support treatment decisions in patients with acute uncomplicated diverticulitis.
Depending on these factors, patients may be managed with or without antibiotics.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Treatment failure
Tidsramme: Within 90 days after diagnosis
|
Treatment failure is defined as a composite outcome including progression to complicated diverticulitis requiring percutaneous abscess drainage or surgery, delayed initiation of antibiotics after initial management without antibiotics, or unplanned hospital admission following initial outpatient treatment.
|
Within 90 days after diagnosis
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Antibiotic use
Tidsramme: Within 90 days after diagnosis
|
Proportion of participants receiving antibiotics
|
Within 90 days after diagnosis
|
|
Adherence to the standardized treatment approach
Tidsramme: At the initial treatment decision
|
Proportion of participants whose management is consistent with the standardized treatment approach.
|
At the initial treatment decision
|
|
Outpatient versus inpatient management
Tidsramme: At the initial treatment decision
|
roportion of participants initially managed as outpatients versus inpatients.
|
At the initial treatment decision
|
|
Hospital admission
Tidsramme: Within 30 days after diagnosis
|
Proportion of participants readmitted to hospital.
|
Within 30 days after diagnosis
|
|
Recurrence of diverticulitis
Tidsramme: Within 24 months after diagnosis
|
Proportion of participants experiencing recurrence of diverticulitis.
|
Within 24 months after diagnosis
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Dimitri Christoforidis, MD, EOC
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- ORL-CHIR-040_aud
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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