6/28/23, 1:16 AM DINAMO-study Pathway Feedback Search Clinical Topics Home Studies DINAMO-study DINAMO-study Disease Acute diverticulitis Trial question Is nonantibiotic outpatient treatment noninferior to antibiotic treatment in patients with mild acute diverticulitis? Study design Multi-center Open label RCT Population Characteristics of study participants 53.0% female N = 480 47.0% male 480 patients (256 female, 224 male) Inclusion criteria: adult patients consulting the emergency department with symptoms of acute diverticulitis Key exclusion criteria: age < 18 years or > 80 years; allergy to any of the study drugs; modified Neff grade I or upper acute diverticulitis; acute diverticulitis episode in the last 3 months; antibiotic treatment for any reason in the last 2 weeks; presence of significant comorbidities Interventions N=242 non-antibiotic (anti-inflammatory and symptomatic treatment with 600 mg/8 hour ibuprofen alternating with 1 g/8 hour acetaminophen) https://web.pathway.md/studies/recum7QuE10UtWf51 1/2 6/28/23, 1:16 AM DINAMO-study Pathway N=238 antibiotic (875 mg/125 mg/8 hour amoxicillin-clavulanate apart from anti-inflammatory and symptomatic treatment) Primary outcome Hospital admission 5.8 % 5.8 4.3 % 3.3 2.9 % Difference not exceeding nonferiority margin 1.4 % 0.0 % Non-antibiotic Antibiotic Difference not exceeding nonferiority margin in hospital admission (3.3% vs. 5.8%; ARD -2.58, 95% CI -1.17 to 6.32) Secondary outcomes No significant difference in emergency department revisits (7% vs. 6.7%; AD 0.3%, 95% CI -4.83 to 4.22) No significant difference in the percentage of patients with poor pain control at 2 days (2.3% vs. 5.7%; ARD -3.39, 95% CI -0.18 to 6.96) Conclusion In adult patients consulting the emergency department with symptoms of acute diverticulitis, non- antibiotic was noninferior to antibiotic with respect to hospital admission. Reference Laura Mora-L pez, Neus Ruiz-Edo, Oscar Estrada-Ferrer et al. Efficacy and Safety of Nonantibiotic Outpatient Treatment in Mild Acute Diverticulitis (DINAMO-study): A Multicentre, Randomised, Open-label, Noninferiority Trial. Ann Surg. 2021 Nov 1;274(5):e435-e442. Open reference URL https://web.pathway.md/studies/recum7QuE10UtWf51 2/2