Acute Pancreatitis: Should We Use Antibiotics?

Abstract

Acute pancreatitis is a common cause of hospitalization and a major source of morbidity worldwide. When it is severe, and especially when it progresses to include necrosis of the pancreas, the risk of infection rises and mortality increases. Early reports suggested prophylactic antibiotics given in severe pancreatitis prevent infection and death. More recent clinical trials do not support this benefit, and meta-analyses on the topic offer conflicting recommendations. In this article, we evaluate the body of published literature examining the use of antibiotics as a preventive measure in acute pancreatitis. The highest quality, currently available data fail to support prophylactic use of antibiotics, which should be added to treatment regimens only where infection has been proven.

Acute Pancreatitis: What's the Score?

“…Morphine remains an effective analgesic agent and should not be excluded due to lack of evidence of spasm of the sphincter of Oddi (18). Broad-spectrum antibiotics should not be used in patients with AP unless infected necrosis is identified (19). ERCP with sphincterotomy and stone extraction is indicated in patients with suspected biliary obstruction or in whom cholecystectomy is contraindicated.…”

Acute kidney injury following acute pancreatitis: A review

“…However, cross-sectional imaging in the early phase of evaluation is not associated with improved outcome, but is very important and usually used between 48-72 h after hospitalisation. Antibiotic treatment in SAP is still a controversial option and some studies recommend use of antibiotics agents only if the complications of sepsis are presented but not for their prevention [63][64][65] . In addition, broad spectrum antibiotics with good tissue penetration are necessary to prevent infection in SAP after CT-proven pancreatic necrosis 66 .…”

Calcio sérico total y calcio corregido como predictores de severidad en pancreatitis aguda

“…El curso clínico varía significativamente de persona a persona. Aunque generalmente es autolimitada, utilizando los criterios de clasificación de la PA de 1992 se ha determinado que en promedio, un 20% de los pacientes presentan una afección grave, y estos últimos tienen una mortalidad del 50% 6,7 . La utilización de las escalas pronósticas permite detectar a los casos graves y establecer de manera oportuna un manejo adecuado 8 .…”