2010 The Authors. The other ingredient, which is called clavulanic acid, helps the amoxicillin in Augmentin work against bacteria that are normally resistant to amoxicillin when its used alone. 13 Sources. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist. Method: This pain typically is colicky in nature, but can be steady, and often is relieved by passing flatus or having a bowel movement. MeSH Examples of other drugs that may be used to treat urinary tract infection (UTI) include: Examples of other drugs that may be used to treat sinus infections include: Examples of other drugs that may be used to treat skin infections include: Examples of other drugs that may be used to treat ear infections include: Examples of other drugs that may be used to treat pneumonia include: Taking too much of this medication can increase your risk of severe side effects. Bethesda, MD 20894, Web Policies Spread out the doses so that theyre about 12 hours apart. For severe infection, refer to severe secondary peritonitis. Expand current row for information about metronidazole, Expand current row for information about ciprofloxacin, Expand current row for information about Flagyl, Expand current row for information about Cipro, Expand current row for information about Bactrim DS, Expand current row for information about clindamycin, Expand current row for information about sulfamethoxazole / trimethoprim, Expand current row for information about Bactrim, Expand current row for information about Flagyl IV. 2017 Nov 25;11(11):CD009277. If your dog or cat eats your prescription Augmentin, call your vet right away. Reproduction in whole or in part without permission is prohibited. When the patient has left lower quadrant tenderness and a CRP level greater than 50 mg per L (476.20 nmol per L) in the absence of vomiting, the likelihood of acute Augmentin kills bacteria by attaching to proteins within the bacteria cell. doi: 10.1002/14651858.CD009277.pub2. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3. anticholinergics/antispasmodics. You can Diverticula generally are multiple. Online ahead of print. It may also be reserved for those who have had previous ear infections that were not effectively treated by amoxicillin. No, theyre different medications. Thomas AR, Eyada M, Kono M, Varatharajalu K, Lu Y, Xu G, Panneerselvam K, Shatila M, Altan M, Wang J, Thompson JA, Zhang HC, Khan MA, Raju GS, Thomas AS, Wang Y. J Cancer Res Clin Oncol. If this septic process erodes into adjacent structures, it may result in fistula formation. If youre feeling better and want to stop Augmentin early, be sure to ask your doctor if its safe to do so. A high-fiber diet may also be recommended to help prevent future diverticulitis flare-ups. Amoxicillin-clavulanate (875mg/125mg) PO BID or amoxicillin-clavulanate extended release (1,000mg/62.5mg) PO BID or Moxifloxacin 400mg PO daily Duration of Augmentin side effects: What you should know. By Sarah Bence. 2019 Feb;23(2):87-100. doi: 10.1007/s10151-018-1919-6. The https:// ensures that you are connecting to the Management without antibiotics can be considered in patients with uncomplicated disease (no signs of severe infection, no evidence of fistula or abscess, not immunosuppressed) Objectives: To assess the effects of antibiotic interventions for uncomplicated diverticulitis on relevant outcome. Ultrasonography was found to have a specificity of 99.8 percent in one large retrospective study.16. Antibiotics to prevent complications following tooth extractions. Although the sensitivity is excellent (97 percent), a normal CT does not preclude the diagnosis. Its good for 10 days in the refrigerator. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Has a potential for abuse less than those in schedules 1 and 2. WebBackground: The American Academy of Pediatrics 2004 guidelines on diagnosis and management of acute otitis media (OM) recommends use of high-dose amoxicillin for the treatment of acute uncomplicated OM. Using medical claims data from 2000 to 2018, researchers identified nearly 120,000 adults aged 18 to 64 who Consensus guidelines6 recommend a high-fiber diet in these patients to prevent symptomatic diverticular disease, although there are no randomized controlled trials to support or refute this strategy. Cipro (ciprofloxacin) is a prescription medication thats used to treat infections caused by bacteria. sulfonamides, Brand names: Symptomatic diverticular disease, also known as symptomatic diverticulosis, is characterized by nonspecific attacks of abdominal pain without evidence of an inflammatory process. Some may be better suited for you than others. Epub 2020 Jul 18. Nasogastric suction is not indicated unless there is significant ileus. Ninety-six patients were diagnosed with uncomplicated acute diverticulitis and 26 presented at least one criterion for admission. Symptoms of an overdose of Augmentin can include: If you think you or your child has taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. If this occurs, contact your doctor. Flagyl has an average rating of 6.5 out of 10 from a total of 73 ratings for the treatment of Diverticulitis. 51% of reviewers reported a positive effect, while 19% reported a negative effect. 73 ratings from 80 user reviews. Compare all 20 medications used in the treatment of Diverticulitis. Please DO NOT take Flagyl. Activity is based on recent site visitor activity relative to other medications in the list. Clavulanic acid is also a beta-lactam that can inactivate some forms of beta-lactamase. Disclaimer. AHFS DI Monograph, Prescribing Information, Brand names: Admission was indicated in patients not able to tolerate oral intake and those with comorbidity or without adequate family support. It is important to emphasize that the evidence on the effectiveness of probiotics for diverticulitis is still inconclusive, and more research is needed. Augmentin XR is usually considered a second-choice antibiotic for diverticulitis. WebDiverticulitis. An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives. This site needs JavaScript to work properly. Because of the theoretic potential to exacerbate perforation, endoscopic examination is acutely contraindicated unless inflammatory bowel disease, ischemic colitis, or carcinoma is highly suspected.17 Colonoscopy always should be performed six to eight weeks after recovery from acute diverticulitis to exclude coexisting neoplastic disease. Epub 2009 Feb 5. Optimising prescribing of antibiotics in the community is important because it is where most antibiotics are prescribed. and transmitted securely. Tylenol (acetaminophen) or a heating pad for abdominal pain. Steroids also may mask symptoms and delay appropriate therapy. Learn about their differences and possible. One of the two remaining trials compared single to double compound antibiotic therapy and, due to wide confidence intervals, the estimate was imprecise and indicated an uncertain clinical effect between these two antibiotic regimens (RR 0.70; 95% CI 0.11 to 4.58; 51 participants; 1 study; low-certainty evidence). Hyosyne, The generic version of this drug is available in the same forms as Augmentin, as well as in a chewable tablet. The generic name of Augmentin is amoxicillin/clavulanate potassium. The dry powder for the liquid suspension should also be stored at room temperature. Only three RCTs on the need for antibiotics are currently available. When used to treat pneumonia, Augmentin and Augmentin XR are typically used in combination with other antibiotics. It takes a few days: You don't say how long since you started the antibiotics. It takes a few days for diverticulitis and similar infections to improve with antibioti It takes a few days for diverticulitis and similar infections to improve with antibioti Approximately 85 percent of patients with diverticula are believed to remain asymptomatic. Your pharmacist will determine the concentration of the suspension and the amount your child should take based on their doctors prescription. Typical findings include spiculation of the mucosa, spasm, abscess, or evidence of frank perforation. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it. Careers. All patients diagnosed with uncomplicated diverticulitis based on abdominal computed tomography findings from June 2003 to December 2008 were considered for outpatient treatment. and transmitted securely. Traditionally, diverticula are identified by barium enema, and additional investigations are performed as indicated to rule out other potential causes of symptoms in individual patients. It contains two components: amoxicillin and clavulanic acid. Kim JY, Park SG, Kang HJ, Lim YA, Pak KH, Yoo T, Cho WT, Shin DW, Kim JW. As with patients receiving out-patient therapy, hospitalized patients should improve within 48 to 72 hours. Symptomatic disease without inflammation is a diagnosis of exclusion requiring colonoscopy because imaging studies cannot discern the significance of diverticula. Diverticulitis is believed to develop as the result of a micro- or macro-perforation of a diverticulum, which may be caused by erosion of the luminal wall by increased intraluminal pressure or thickened fecal material in the neck of the diverticulum. However, Augmentin is usually not the first-choice antibiotic for treating cellulitis. Treatment is typically antibiotics for seven to 10 days. Accessibility In some cases, one or more of the pouches become inflamed or infected. Cochrane Database Syst Rev. Hospitalization is recommended if patients show signs of significant inflammation, are unable to take oral fluids, are older than 85 years, or have significant comorbid conditions. Bowel sounds often are decreased but may be normal early in the condition or increased in the presence of obstruction. For unknown reasons, only a small percentage of patients with diverticulosis develop symptomatic diverticular disease. Augmentin and Augmentin XR are FDA-approved for treating pneumonia. The colon can become obstructed because of luminal narrowing caused by inflammation or compression by an abscess. Bookshelf Results: The arrowhead sign consists of focal thickening of the colonic wall with an arrowhead-shaped lumen pointing to the inflamed diverticula ( Figure 2Figure 2).14 In one large prospective study,15 investigators demonstrated the ability of CT to accurately predict medical treatment failure or risk of complications by determining the presence of severe disease (abscess or extraluminal air or contrast). These patients should be placed on bowel rest and treated with intravenous fluids and intravenous antibiotics ( Table 3Table 36). HHS Vulnerability Disclosure, Help Abscesses occur when the pericolic tissues fail to control the spread of the inflammatory process. The general and surgical management of these infections are discussed in detail elsewhere. The liquid suspension form of Augmentin is typically used for children. doi: 10.7759/cureus.27159. Treatment consisted of oral antibiotics for 7 days (amoxicillin-clavulanic or ciprofloxacin plus metronidazole in patients with penicillin allergy). Veterinarians sometimes prescribe Augmentin to treat infections in dogs and cats. Martn Gil J, Serralta De Colsa D, Garca Marn A, Vaquero Rodrguez A, Rey Valcrcel C, Prez Daz MD, Sanz Snchez M, Turgano Fuentes F. Gastroenterol Hepatol. Antibiotics: choices for common infections. Cipro XR, For professionals: Would you like email updates of new search results? Hematochezia is rare and should suggest other diagnoses.3. Diverticular colitis. E. coli . Augmentin starts working within a few hours of when you take it. However, according to the American Academy of Pediatrics, Augmentin is not usually the first-choice antibiotic for treating ear infections in children. Uncomplicated diverticulitis has traditionally been treated with antibiotics, as diverticulitis has been regarded as an infectious disease. Bookshelf Authors' conclusions: Its used to treat infections caused by bacteria. WebDiverticulitis is found among people who take Amoxicillin and clavulanate potassium, especially for people who are female, 60+ old, have been taking the drug fo Age of people who have Diverticulitis when taking Amoxicillin and clavulanate potassium *: 0-1: 0.0 % ; 2-9: 0.0 % ; 10-19: 0.0 % (the brand name). Augmentin should only be used during pregnancy if theres a clear need for its use. However, findings in about 10% of patients cannot distinguish diverticulitis from colon cancer. However, animal studies dont always predict the way humans would respond. The combination of amoxicillin and clavulanic acid extends the spectrum of Augmentin against bacteria that are normally resistant to amoxicillin alone. How long a medication remains good can depend on many factors, including how and where the medication is stored. Careers. Copyright 2005 by the American Academy of Family Physicians. Augmentin is taken two or three times daily. Applies to the following strengths: 250 mg; 500 mg; 125 mg/5 mL; 50 mg/mL; By following a liquid diet as much as possible, with the occasional boiled or roasted vegetable and raw whole foods such as The Cochrane Collaboration's tool for assessing risk of bias was used to assess the methodological quality of the identified trials. Beta-lactamase-producing bacteria are resistant to amoxicillin. Amoxicillin dosage for infants over one month is the same as for older children. Sulfatrim Pediatric Cleocin Phosphate Different drug interactions can cause different effects. Expand current row for information about Cipro I.V. Augmentin is not FDA-approved for treating diverticulitis. Uncomplicated diverticulitis has traditionally been treated with antibiotics, as diverticulitis has been regarded as an infectious disease. Patients were seen again at If generalized peritonitis develops, the mortality rate is even higher. The true prevalence of diverticula is unknown, but in one large observational study5 of 9,086 consecutive patients undergoing colonoscopy for all indications, the overall prevalence of diverticulosis was 27 percent and increased with patient age. It has a currently accepted medical use in treatment in the United States. In some cases, this can include bronchitis. If right upper quadrant pain or elevated transaminase levels occur, evidence of a pyogenic liver abscess should be sought. Immediate relief for mild symptoms during a diverticulitis flare-up may include: A clear liquid diet. Has a low potential for abuse relative to those in schedule 3. Different doses of this drug are used for animals than for humans, so dont try to treat your pet with a human prescription of Augmentin. Praxis (Bern 1994). Also tell them about any vitamins, herbs, and supplements you use. In addition to those side effects, children can experience tooth discoloration. Common choices are metronidazole (Flagyl) plus a quinolone; metronidazole plus trimethoprim-sulfamethoxazole (Bactrim, Septra); or amoxicillinclavulanic acid (Augmentin).6 Patients also should follow a clear liquid diet. amebicides, miscellaneous antibiotics, For consumers: Examples of side effects that might be more likely to occur or worsen with alcohol use include: Augmentin can interact with several other medications. However, its common for people who are fighting infections to feel fatigued, tired, or weak. Can poor sleep impact your weight loss goals? Septra DS, Diverticulosis is an anatomic diagnosis that describes the presence of one or more diverticula. All rights reserved. In severe cases, surgery may be required to remove the affected portion of the intestine. In patients with uncomplicated diverticulitis who are clinically stable and able to tolerate fluids, outpatient treatment with broad-spectrum antibiotics covering anaerobes and gram-negative rods is appropriate ( Table 3Table 36). Patients were seen again at between 4 and 7 days after starting treatment to confirm symptom improvement. Diverticular hemorrhage is a possible complication of diverticulosis, and it is the most common cause of major lower gastrointestinal (GI) bleeding. Call your doctor right away if you have serious side effects. Oh MY, Shin R, Heo SC, Lim HK, Kim MJ, Park JW, Ryoo SB, Jeong SY, Park KJ. Predisposing factors for the formation of diverticula include a low-fiber diet and physical inactivity. Selection criteria: Immature band forms may be present. The site is secure. 8600 Rockville Pike The purpose of such expiration dates is to guarantee the effectiveness of the medication during this time. PMC Approximately 20% of patients with diverticulosis will become symptomatic. The approach to antimicrobial selection and administration for intra-abdominal infections in adults is discussed here. thinner wall of the right colon . Published by John Wiley & Sons, Ltd. WebOtitis media- 75 - 100 mg/kg/day given in 4 divided doses for 5 - 10 days (PI) Strep throat- 40 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 10 days (IDSA) Urinary tract infection- 50 - 100 mg/kg/day (max 2000 mg/day) given in 4 divided doses for 7 - 14 days (CTE) Adults (15 years and older) It's not clear yet if we can prevent diverticulosis or diverticulitis. [Diverticulitis (acute)/diverticulosis of the colon]. A high-fiber diet may also be recommended to help prevent future diverticulitis flare-ups. Random-effects meta-analyses were performed with the Mantel-Haenzel method. Oscimin, All patients with symptomatic diverticular disease should undergo colonoscopy to exclude underlying neoplasm. 2006 Dec;80(6):369-72. doi: 10.1016/s0009-739x(06)70989-7. Nevertheless, a high-fiber diet, fiber supplementation, or both generally are recommended and are likely to do no harm. Different classifications exist to try to categorize it but, it is generally considered as complicated or Of patients with diverticula, 80 to 85 percent are believed to remain asymptomatic. The .gov means its official. Curr Probl Surg. Co-trimoxazole, Although the pathogenic mechanisms of diverticular disease are poorly understood, they are clearly related to complex interactions of colon structure, intestinal motility, diet, and genetic features.4. Abuse may lead to moderate or low physical dependence or high psychological dependence. An official website of the United States government. Drinking alcohol while taking Augmentin may increase your risk of certain side effects, or make your side effects worse. By Sarah Bence. The remaining one fourth (or approximately 5 percent of all patients with diverticula) develop diverticulitis, and a small number will develop complications of diverticulitis such as abscess formation, fistulas, obstruction, or hemorrhage.6 Table 1Table 1 compares the various diverticular syndromes. The most common sign that you have it is feeling sore or sensitive on the left side of your lower belly. Abscess formation should be suspected when fever, leukocytosis, or both persist despite an adequate trial of appropriate antibiotics. If you experience them, it doesnt mean you have an allergy to the medication. government site. Currently there is no medication available to prevent recurrence of diverticulitis. The quality of the evidence is low. If youre concerned about how tired you feel while you take Augmentin, talk to your doctor. antibiotics, although not all people with diverticulitis need these medicines. Studies in animals have not found any harm to the fetus when given to pregnant mothers. The last trial compared short to long intravenous administration of antibiotics and did not report any events for our primary outcomes. doi: 10.1002/14651858.CD009092.pub2. Below is a list of medications that can interact with Augmentin. Diverticulitis: An Update From the Age Old Paradigm. Can diet help improve depression symptoms? The oral bioavailability of the amoxicillin component of Augmentin is about 74 percent to 92 percent. Augmentin is a penicillin-type antibiotic. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks. Is the outpatient management of acute diverticulitis safe and effective? Perforation has been linked to nonsteroidal anti-inflammatory drug (NSAID) use in case-control studies.20 Glucocorticoids may increase this risk. Federal government websites often end in .gov or .mil. Before taking Augmentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Antibiotic therapy aimed at anaerobes and gram-negative rods is first-line The drug has multiple schedules. Flagyl, Amoxicillin is one of the most commonly prescribed antibiotics and is used to treat everything from bronchitis to pneumonia to ear infections, tonsillitis, and more. However, its used off-label to treat it. A systematic review and meta-analysis. If youre breastfeeding your child, talk with your doctor before taking Augmentin. Augmentin contains amoxicillin and clavulanic acid. Cipro, 2017 Feb 22;2(2):CD012131. The https:// ensures that you are connecting to the Best food forward: Are algae the future of sustainable nutrition? The Augmentin liquid suspension form may be used instead of the tablet for adults who have trouble swallowing pills. Aim: The peak blood level of amoxicillin and clavulanic acid occurs between one and two-and-a-half hours after oral intake. The more common side effects of Augmentin include: These side effects may go away within a few days or a couple of weeks. The clavulanic acid ingredient makes Augmentin effective against bacteria that amoxicillin or other penicillin drugs may not work against when theyre taken by themselves. Nature's medicine is the fastest way to ensure your digestive tract gets proper cleansing and can rebuild itself with new walls. Epub 2012 Jun 16. In 2015, 30% of all patients attending a general practice received an antibiotic prescription. Individual patient circumstances and local resistance patterns may alter treatment choices. Abraha I, Binda GA, Montedori A, Arezzo A, Cirocchi R. Cochrane Database Syst Rev. For patients receiving antibiotics for outpatient diverticulitis, amoxicillinclavulanate seems preferable to metronidazole plus a fluoroquinolone, according to an observational study in the Annals of Internal Medicine. The following list contains some of the key side effects that may occur while taking Augmentin. Close follow-up is recommended, and hospitalization should be considered if the patient experiences increasing pain, fever, or an inability to tolerate fluids. sharing sensitive information, make sure youre on a federal Applicability, safety and efficiency of outpatient treatment in uncomplicated diverticulitis. Copyright 2000 - 2023 Jobson Medical Information LLC unless otherwise noted. The overall quality of evidence for outcomes was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Risk Factors Symax SL, MRI is an alternative for pregnant and young patients ( 1 , 2 ). This list does not include all possible side effects. Theyre also contraindicated in people with a history of cholestatic jaundice or liver dysfunction following treatment with Augmentin. 1 Most are for acute respiratory infections, and in quantities several-fold more than recommended by Australian guidelines. However, for diverticulitis, Augmentin is usually preferred than plain amoxicillin. A total of 5ml Learn about its more common, mild, and serious side effects, Augmentin and amoxicillin are similar antibiotics that doctors prescribe to treat bacterial infections. Please enable it to take advantage of the complete set of features! This antibiotic can cause such side effects as headaches, rashes, nausea and vomiting and restlessness. In as many as 16 percent of patients with diverticular hemorrhage, bleeding may be the first sign of diverticular disease and is abrupt, voluminous, and painless in onset. The following information is a consensus guide. WebCrohns Disease is a type of inflammatory bowel disease (IBD) that can cause similar symptoms to diverticulitis, including abdominal cramps, bloating, diarrhea, fatigue, unintended weight loss, and, sometimes, rectal bleeding. Augmentin is FDA-approved for treating UTI. In many cases, its important to finish the entire treatment to ensure that the infection does not come back. The decision about which option to choose is best guided by an experienced surgeon and the patients preference. WebYou can also try ground psyllium seed: Once a day, add 1 teaspoon ground psyllium seed over any cold liquid and drink within a few minutes of preparing, before the mixture gels. If you take it three times daily, spread out the doses so that theyre roughly eight hours apart. Augmentin tablets or powder and Augmentin XR should be stored in the original container at temperatures of 77 degrees F (25 degrees C) or less. Whether treatment is administered on an inpatient or out-patient basis is determined by the clinical status of the patient and his or her ability to tolerate oral intake. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. WebInfo: for empiric tx in low-risk pts; give w/ ciprofloxacin; dose based on amoxicillin component; if 45 mg/kg/day regimen, use 200 mg/28.5 mg or 400 mg/57 mg forms; if 90 mg/kg/day regimen and wt 40 kg, use 600 mg/42.9 mg/5 mL susp avail. If you have an allergic reaction, you may need to be treated with a different antibiotic. With diverticulitis, an abscess may appear in the abdomen. In severe cases, surgery may be required to remove the affected portion of the intestine. What is the recommended dosage of amoxicillin for a 50 lb child with strep throat? Its commonly used for skin infections and gum disease in animals, but may also be used for other kinds of infections. Please enable it to take advantage of the complete set of features! The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). We want to reduce traffic in your GI tract so that nothing else irritates them, says Taylor. Prompt surgical consultation also should be obtained when there is evidence of abscess formation, fistula formation, obstruction, or free perforation. Cleocin, the type and severity of the condition youre using Augmentin to treat, immediate-release tablet: 250 mg/125 mg, 500 mg/125 mg, 875 mg/125 mg, extended-release tablet: 1,000 mg/62.5 mg, liquid suspension: 125 mg/31.25 mg per 5 mL, 250 mg/62.5 mg per 5 mL, vaginitis (caused by problems such as yeast infection), yellowing of your skin or the whites of your eyes, trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim), doxycycline (Acticlate, Doryx, Doryx MPC, Vibramycin), doxycycline (Acticlate, Doryx, Doryx MPC). Amoxicillin Dosage Medically reviewed by Drugs.com. A doctor may do tests to check for problems with your heart, liver, or kidneys, or breathing issues. Lodi G, Azzi L, Varoni EM, Pentenero M, Del Fabbro M, Carrassi A, Sardella A, Manfredi M. Cochrane Database Syst Rev. 2019 Aug;34(8):1413-1420. doi: 10.1007/s00384-019-03343-w. Epub 2019 Jul 2. Disagreements were resolved by discussion or involvement of the third author. Augmentin and Augmentin XR are contraindicated in people with a history of serious hypersensitivity reactions to amoxicillin, clavulanic acid, penicillin, or cephalosporin antibiotics. Has a high potential for abuse. Some of these uses are approved by the Food and Drug Administration (FDA) and some are off-label. Main results: If you become fatigued after starting Augmentin, or your symptoms are not improving, talk to your doctor. Patients with suspected diverticulitis should undergo computed tomography with intravenous and oral contrast rather than other diagnostic modalities such as endoscopy or contrast radiography. Septra, [Safety and efficiency of ambulatory treatment of acute diverticulitis]. If barium enema is performed, water-soluble contrast should be used. The 2015 American Gastroenterological Association (AGA) guidelines stated that clinicians must be selective in using antibiotics in patients in this subgroup of patients.
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