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No Antibiotics for Diverticulitis…and other stuff the residents taught me this week

June 30, 2018

Written by Clay Smith

What I Learned This Week

As an academic physician, I teach Emergency Medicine.  But the one who learns the most is the teacher.  After almost twenty years as a doctor, constantly reading, it never ceases to amaze me how much I still don’t know.  One of the highlights of my job is working with great residents who also teach me.  This week was no exception.  Here are two things I learned from our residents this week.

No Antibiotics for Diverticulitis?

There are two RCTs, this one and this one, in which half of patients with mild diverticulitis did not receive antibiotics.  Surprisingly, those with no antibiotics did just as well.  But this word of caution – almost all were hospitalized for IV fluids, and all were select, uncomplicated cases.  This may be hard to broadly generalize to the outpatient setting.  I’m still skeptical about this but want to learn more.  For now, if my colon explodes, even just a little, I still think I want antibiotics.  Thanks Ryan Van Nostrand – off to a great start as our new education fellow!

HEART Pathway App

I like the simplicity of MDCalc for the HEART score.  But if you want to make sure you are scoring it correctly, as they did in the original HEART study, you need to get a bit more granular.  The HEART Pathway app lets you do that and export to Epic.  Pretty slick.  The actual HEART score website recommends Calculate by QxMD, which is available on Apple and Android.  Thanks Joe Sikon (via Sean Collins)!

Your Turn

Use the comments on the JF website or on Twitter | Facebook and share what you learned this week!

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