Audit of a Novel Nurse-Led Program for Non-Antibiotic Management of Acute Uncomplicated Diverticulitis.

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Non-antibiotic outpatient treatment of acute uncomplicated diverticulitis is safe; however, uptake remains low. To assess the success of non-antibiotic management of uncomplicated diverticulitis through a nurse clinician-led outpatient program. Retrospective audit from June 2022-March 2024. Nurse clinician-led outpatient program for non-antibiotic management of acute uncomplicated diverticulitis at a university-affiliated hospital. Immunocompetent adults with CT-proven acute uncomplicated diverticulitis and C-reactive protein <150 mg/L. Eligible patients not referred to the program but treated in the Emergency Department during the same time period were also reviewed. This program included education, diet modification, analgesia, clinic visit, and telephone follow-ups by a nurse-clinician. Primary outcome was success of the program, defined as the proportion not requiring an Emergency Department visit, admissions within 60 days of diagnosis or need for antibiotics. Of 236 patients referred to the program, 84 met inclusion criteria, of which 43 (51.2%) were started on antibiotics before referral but were treated by the program. Forty-one (48.8%) completed the non-antibiotic protocol (48.8%, n = 41), with 97.6% success. Concurrently, 219 eligible patients were treated in the Emergency Department but not referred to the program. There was no difference in the number of Emergency Department visits between the 2 groups [program: n = 7 (8.3%) vs Emergency Department: n = 27 (12.3%)] within 60 days of diagnosis. Two patients (2.3%) treated in the program required admission, while 7 (3.2%) patients in the Emergency Department group were admitted. Overall, antibiotics were started before referral in 51.2% of patients in the program compared to 92.2% in the Emergency Department (p < 0.005). Modest sample size, single institutional data and retrospective design. Implementation of non-antibiotic treatment for mild acute uncomplicated diverticulitis can be successful using an outpatient nurse-clinician led program with referrals from the Emergency Department and community. See Video Abstract.