ClinicalTrials.gg
Not yet recruitingNCT07352605Updated Jan 20, 2026

Percutaneous Drainage Versus Antibiotic Therapy for Acute Diverticulitis With Abscess.

An interventional study of Arm 1 (Control Arm) - Percutaneous drainage plus antibiotics: Image-guided (CT or ultrasound) percutaneous drainage performed within 48 hours of randomization with intravenous bro and Arm 2 (Experimental Arm) - Antibiotics alone: Intravenous broad-spectrum antibiotics: piperacillin-tazobactam 4 g/0.5 g q6h (dosage to be adjusted based on renal function) according to the recent lite in Diverticular Disease of Colon, sponsored by Azienda Sanitaria di Firenze. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-01-20.

Sponsored by Azienda Sanitaria di Firenze · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

the management of diverticular abscesses is guided by consensus-based recommendations from the WSES guidelines, the American College of Physicians, and the American Gastroenterological Association, all of which acknowledge the predominance of anecdotal and observational evidence and the urgent need for randomized controlled trials to inform clinical practice.The PANDA trial (Percutaneous drainage versus Antibiotic therapy for acute Diverticulitis with Abscess. Randomized controlled trial) is designed to address this evidence gap by directly comparing percutaneous drainage plus antibiotics versus antibiotics alone in patients with acute diverticulitis and large abscesses (WSES stage 2A). By employing strict inclusion criteria, standardized interventions, and predefined outcome measures, this study aims to clarify the relative efficacy, safety, and long-term impact of the two strategies, thereby guiding future clinical decision-making and informing guideline recommendations.

However, before we can proceed with the launch of the PANDA trial, we need to start a pilot study that will allow us to understand both the methodological and practical feasibility of starting this pilot study.

Primary objective The PANDA trial pilot study want to evaluate the local feasibility of the individual centers under study. Specifically, the primary objective will be to assess a minimum adherence rate of 70% for each participating center out of all patients with acute diverticulitis WSES 2A being evaluated. Adherence refers to the ability to enroll patients, randomize them, and perform clinical follow-up.

Secondary objectives The Panda trial pilot study want to compare the efficacy of antibiotic therapy alone versus percutaneous drainage plus antibiotic therapy in achieving complete clinical resolution at 30 days in patients with acute diverticulitis classified as WSES stage 2A, presenting with a pericolic or distant abscess ≥4 cm and \< 8 cm in size.

In addition the PANDA trial pilot study wants to compare the rate of treatment failure, defined as the need for urgent surgical intervention (e.g., colectomy, resection with or without stoma formation) within 30 days.

Moreover the PANDA trial aimed to asses: the recurrence rate of diverticulitis after 90 days, defined as a new clinical episode confirmed radiologically and requiring hospital admission; to evaluate the length of hospital stay; to record and compare adverse events related to each treatment strategy, graded according to the Clavien-Dindo classification, with a focus on procedure-specific complications in the drainage arm.

Study Design

The PANDA trial pilot study is a prospective, multicentre, open-label, randomized controlled trial designed to compare two accepted non operative strategies for the management of large diverticular abscesses (WSES 2A Stage) to evaluate the methodological and structural feasibility of a national RCT. Participating centres will include high-volume emergency and general surgery units with access to both advanced interventional radiology and standardized medical management protocols. Two Intervention arms:

  • Arm 1 (Control Arm) - Percutaneous drainage plus antibiotics.
  • Arm 2 (Experimental Arm) - Antibiotics alone

In both arms the patients will be evaluated daily clinically and through laboratory tests.

Collaborators at each participating center will prospectively collect data for all eligible patients for 6 months followed by 3 months of follow-up.

02

Conditions studied

  • Diverticular Disease of Colon

Keywords

  • Diverticulitis, Colonic diverticular abscess
03

In context

Diverticulosis, Colonic

23 studies on the registry are indexed under Diverticulosis, Colonic; 4 are open to participants now.

This study's planned enrollment of 50 is below the median of 80 across 13 interventional studies indexed under Diverticulosis, Colonic.

Browse Diverticulosis, Colonic studies →

Lead sponsor

Azienda Sanitaria di Firenze is the lead sponsor of 5 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients of both sexes, ≥ 18 years old.
  • Patients with abdominal CT scan diagnosis of colonic AD classifiable as WSES 2A with abscess ≥4 cm and \< 8 cm in size;
  • Patients with haemodynamic stability at hospital admission and no clinical or radiological evidence of diffuse peritonitis.
  • Patients who accept and sign the

Exclusion criteria

Exclusion criteria

  • Patients with a final diagnosis other than diverticular abscess, including those diagnosed with colonic cancer.
  • Pregnancy or lactation.
  • patients.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
50 participants (estimated)

Study arms

  • Sham comparator
    Percutaneous drainage plus antibiotics.

    Patients with diverticular abscess greater than 4 cm in diameter who undergo percutaneous drainage and antibiotic therapy

    Procedure: Arm 1 (Control Arm) - Percutaneous drainage plus antibiotics: Image-guided (CT or ultrasound) percutaneous drainage performed within 48 hours of randomization with intravenous bro

  • Experimental
    Antibiotics alone

    Patients with diverticular abscess larger than 4 cm in diameter who are undergoing antibiotic therapy alone

    Other: Arm 2 (Experimental Arm) - Antibiotics alone: Intravenous broad-spectrum antibiotics: piperacillin-tazobactam 4 g/0.5 g q6h (dosage to be adjusted based on renal function) according to the recent lite

Interventions

  • ProcedureArm 1 (Control Arm) - Percutaneous drainage plus antibiotics: Image-guided (CT or ultrasound) percutaneous drainage performed within 48 hours of randomization with intravenous bro

    CT or ultrasound-guided percutaneous drainage

  • OtherArm 2 (Experimental Arm) - Antibiotics alone: Intravenous broad-spectrum antibiotics: piperacillin-tazobactam 4 g/0.5 g q6h (dosage to be adjusted based on renal function) according to the recent lite

    Antibiotic therapy alone

06

What researchers measure

Primary outcomes

  1. Primary outcome

    The PANDA trial pilot study want to evaluate the local feasibility of the individual centers under study. Specifically, the primary objective will be to assess a minimum adherence rate of 70% for each participating center out of all patients with acute diverticulitis WSES 2A being evaluated. Adherence refers to the ability to enroll patients, randomize them, and perform clinical follow-up.

    Time frame: From enrollment to the end of treatment at 6 months

Secondary outcomes

  1. Secondary outcomes

    The Panda trial pilot study want to compare the efficacy of antibiotic therapy alone versus percutaneous drainage plus antibiotic therapy in achieving complete clinical resolution at 30 days in patients with acute diverticulitis classified as WSES stage 2A, presenting with a pericolic or distant abscess ≥4 cm and \< 8 cm in size. In addition the PANDA trial pilot study wants to compare the rate of treatment failure, defined as the need for urgent surgical intervention (e.g., colectomy, resection with or without stoma formation) within 30 days. Moreover the PANDA trial aimed to asses: the recurrence rate of diverticulitis after 90 days, defined as a new clinical episode confirmed radiologically and requiring hospital admission; to evaluate the length of hospital stay; to record and compare adverse events related to each treatment strategy, graded according to the Clavien-Dindo classification, with a focus on procedure-specific complications in the drainage arm.

    Time frame: From enrollment to the end of treatment at 9 months

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Apr 2026; primary completion for Oct 2026, 6 months later.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 12, 2026
First posted
Jan 20, 2026
StartEst.
Apr 2026
Primary completionEst.
Oct 2026
CompletionEst.
Jan 2027
Last update
Jan 20, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jan 20, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07352605
Lead sponsor
Azienda Sanitaria di Firenze
Responsible party
Alessio Giordano (Professor, Azienda Sanitaria di Firenze) — Principal investigator
First posted
Jan 20, 2026
Start date
Apr 2026 (estimated)
Primary completion
Oct 2026 (estimated)
Completion
Jan 2027 (estimated)
Last update
Jan 20, 2026

Study contacts

Alessio A Giordano
Contact
giordanoa@aou-careggi.toscana.it
00393289221689

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jan 2026. You cannot join it, but the record below documents what was studied.

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