Best Antibiotics for Diverticulitis Treatment

woman taking antibiotics pill
Medically reviewed by Dr. Ola Tarabzuni

Key Takeaways

  • Appropriate antibiotic selection is essential for effective diverticulitis treatment, aiming to target common pathogens and reduce complications.
  • Broad-spectrum antibiotics like ciprofloxacin and metronidazole or amoxicillin-clavulanate are often recommended for complicated cases, while severe or recurrent diverticulitis may require more targeted antibiotics guided by culture results.
  • Combining antibiotics with lifestyle changes, such as a high-fiber diet and regular exercise, can enhance the overall success of diverticulitis treatment and prevent future flare-ups

Diverticulitis is “a blind, tubular sac or processes branching off from a canal or cavity”.

When it comes to treating diverticulitis, finding the right antibiotics can make all the difference in your recovery journey. The best antibiotics for diverticulitis are Ciprofloxacin, Metronidazole(Flagyl), Augmentin (Amoxicillin/Clavulanic Acid), Doxycycline and Trimethoprim/Sulfamethoxazole in different doses and dosage regimens.

In this article, we’ll explore the top choices of medicines favored by medical experts, helping you make an informed decision for a smoother path to healing and better health.

What is Diverticulitis?

Diverticulitis is an enhanced medical condition of Diverticulosis, which is a specific condition of the large intestine. It is the condition in which the small pouches called diverticula appear and become inflamed in the walls of the colon in the large intestine.

These pouches appear in the weak spots of the large intestine and are often associated with the disease diverticulosis which is the presence of these pouches without inflammation or infection.

Diverticulitis can be of two types: 

  • Uncomplicated Diverticulitis (without infection)  
  • Complicated Diverticulitis (can present with infections like an abscess, fistula, obstruction or free perforation) 

Antibiotics for diverticulitis are prescribed for complicated diverticulitis depending on the type and severity of the infection.

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What antibiotics are used for diverticulitis?

The choice of antibiotics to treat complicated diverticulitis can vary according to the severity of the infection in the large intestines. Mostly two or more two combinations of different antibiotics are prescribed for completely treating complicated diverticulitis. 

Ciprofloxacin for Diverticulitis

Ciprofloxacin (Cipro) belongs to the class of antibiotics called fluoroquinolone and is often prescribed for diverticulitis treatment. It works by inhibiting bacterial DNA, an enzyme specifically “gyrase”  essential for bacterial DNA replication.

Ciprofloxacin comes in different dosage forms from tablets to extended-release dosage capsules. It is mostly prescribed in a range from 250 to 750 mg every 12 hours for 14 days for diverticulitis along with the Metronidazole depending on the severity of the infection.

Metronidazole(Flagyl) for Diverticulitis

Metronidazole belongs to the drug class nitroimidazoles and is often prescribed in combination with other drugs for the diverticulitis treatment plan.

Metronidazole usually works by inhibiting the protein synthesis of the bacteria which leads to permanent cell death.

Augmentin (Amoxicillin/Clavulanic Acid) Combination for Diverticulitis

Augmentin is the combination of two drugs Amoxicillin (penicillin antibiotic) and clavulanic acid ( beta-lactamase inhibitor) both of which can be used for effective diverticulitis treatment.

Amoxicillin works by inhibiting the cell wall synthesis for further spread of the infection-causing bacteria while clavulanic acid works as a shield to amoxicillin preventing bacteria from breaking amoxicillin.

Doxycycline for Complicated Diverticulitis

Doxycycline belongs to the drug class tetracyclines. Tetracyclines inhibit protein synthesis in bacteria, preventing their multiplication.

Tetracyclines come with usage caution in pregnancy. They are contraindicated in pregnant women due to the risk of hepatotoxicity( Liver damage) in the mother, permanent discoloration of teeth of the growing fetus (yellowish appearance), as well as disability in the growth of bones.

Trimethoprim/Sulfamethoxazole

It’s a combination of two drugs combined to give the synergistic effect for the effective treatment of diverticulitis. Trimethoprim inhibits bacterial dihydrofolate reductase enzyme activity, inhibiting folic acid synthesis, while sulfamethoxazole inhibits an enzyme involved in the synthesis of bacterial folic acid. Both work on folic acid reduction to gain effective treatment against complicated diverticulitis.

Clindamycin as an Effective Treatment for Diverticulitis

Clindamycin belongs to the drug class “lincomycin antibiotics” and works by inhibiting the protein synthesis of bacteria.

Are you in pain with diverticulitis? See an Online Doctor

What is the new treatment for diverticulitis?

Because of the increased rate of antibiotic resistance development, carbapenems ( a class of beta-lactam antibiotics) are also prescribed and given for complicated diverticulitis for a specific period. 

How long does it take for diverticulitis to heal with antibiotics?

It depends on the type and severity of the disease. For instance, if it’s uncomplicated diverticulitis, it’s good to wait for 3-5 days and it will go away on its own without antibiotics.  

In case of an infection in complicated diverticulitis, it can take 17-20 days for complete treatment. 

What helps severe diverticulitis pain fast?

Severe or complicated diverticulitis can cause pain and it’s good to go with these widely prescribed options.

  1. Liquid diet to give the colon rest and decrease pain
  2. Antibiotics to treat the infection
  3. NSAID or Opioids

It’s good to seek medical consultation for the best treatment regimen.

Consult a Doctor

Most Diverticulitis goes on its own if it’s uncomplicated showing no pain or inflammation symptoms. If it has pain symptoms, it needs medical attention as well as a healthcare provider’s prescription for effective treatment.

FAQs About Antibiotics for Diverticulitis

What foods aggravate diverticulitis?

Foods that are high in fat and low in fiber can aggravate diverticulitis. It’s good to stay on a liquid diet completely for some days to give rest to the colon and heal.

What is diverticulitis pain like?

The pain might be steady and present most of the time, especially during the acute phase of complicated diverticulitis. Physical activity, coughing, or even pressing on the affected area may intensify the pain.

What triggers diverticulitis flare-ups?

Diverticulitis can be triggered and flared up by consuming diets high in fat, constipation, obstruction, genetics, and lifestyle modification. It’s good to keep an eye on your diet as well as the food that might hurt you. Seek medical attention in case of persistent diverticulitis symptoms for professional medical consultation and treatment.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Rezapour M, Stollman N. Antibiotics in Uncomplicated Acute Diverticulitis: To Give or Not to Give? Inflamm Intest Dis. 2018 Dec;3(2):75-79. doi: 10.1159/000489631. Epub 2018 Jul 20. PMID: 30733951; PMCID: PMC6361500.
  • American Family Physicians. Diagnosis and Management of Acute Diverticulitis
  • Mayo Clinic. Diverticulitis
  • Carabotti M, Annibale B, Severi C, Lahner E. Role of Fiber in Symptomatic Uncomplicated Diverticular Disease: A Systematic Review. Nutrients. 2017 Feb 20;9(2):161. doi: 10.3390/nu9020161. PMID: 28230737; PMCID: PMC5331592.
  • InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Diverticular disease and diverticulitis: Surgery for diverticulitis and diverticular disease. 2018 May 17. Available from: https://www.ncbi.nlm.nih.gov/books/NBK506997/
  • InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Diverticular disease and diverticulitis: Treating acute diverticulitis. 2018 May 17. Available from: https://www.ncbi.nlm.nih.gov/books/NBK506996/
  • Longo S, Altobelli E, Castellini C, Vernia F, Valvano M, Magistroni M, Mancusi A, Viscido A, Ashktorab H, Latella G. Non-steroidal anti-inflammatory drugs and acetylsalicylic acid increase the risk of complications of diverticular disease: a meta-analysis of case-control and cohort studies. Int J Colorectal Dis. 2022 Mar;37(3):521-529. doi: 10.1007/s00384-021-04088-1. Epub 2022 Jan 30. PMID: 35094111.

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