Antibiotic resistance is associated with anastomotic leak after surgery for diverticular disease.

INTRODUCTION

Patients with diverticulitis frequently receive multiple courses of antibiotics before surgery, which may promote antibiotic resistance. We hypothesized that antibiotic resistance is associated with anastomotic leak after surgery for diverticular disease.

METHODS

We retrospectively reviewed patients undergoing surgery for diverticular disease and linked microbiology data to our institution's National Surgical Quality Improvement Program database.

RESULTS

From 2016 to 2024, 159 patients underwent surgery for diverticular disease. The rates of anastomotic leak, infectious complications, and mortality were 9%, 29%, and 4%, respectively. Of the 101 (64%) patients with microbiology data, 40% had one or more organisms with antibiotic resistance. After logistic regression, antibiotic resistance was associated with a higher likelihood of anastomotic leak (OR 9.8, 95% CI 1.4-66.1, p = 0.019) and overall infectious complications (OR 3.3, 95% CI 1.3-8.6, p = 0.015).

CONCLUSIONS

Among patients undergoing surgery for diverticular disease, having bacteria with clinically significant antibiotic resistance was associated with a higher likelihood of anastomotic leak and infectious complications.