Prophylaxis for septic complications in acute necrotizing pancreatitis

Claudio Bassi, Gerardo Mangiante, Massimo Falconi, Roberto Salvia, Isabella Frigerio, Paolo Pederzoli

Research output: Contribution to journalArticlepeer-review

Abstract

Because the mortality of severe pancreatitis is higher when infected necrosis supervenes, prevention of infections has become a relevant endpoint for management. The "ideal" drug should be characterized by specific activity against the bacteria known to be responsible for infection and should be able to penetrate the gland in a sufficient concentration. To date there have been eight prospective trials with antibiotics, one on selective digestive decontamination, and others with enteral nutrition. A meta-analysis regarding experiences with antimicrobial drugs reports a significant reduction in the incidence of infected necrosis and pancreatic abscesses during severe pancreatitis. In conclusion, among the several options aimed at reducing infections during necrotizing pancreatitis, the prophylactic use of antibacterial drugs is the only one to have been tested to date in several randomized studies. Strong consideration should be given to treating patients with severe pancreatitis with broadspectrum antibiotics, selective digestive decontamination, and enteral nutrition.

Original languageEnglish
Pages (from-to)211-215
Number of pages5
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume8
Issue number3
DOIs
Publication statusPublished - 2001

Keywords

  • Acute pancreatitis
  • Antibiotics
  • Enteral nutrition
  • Infected pancreatic necrosis
  • Pancreatic abscess

ASJC Scopus subject areas

  • Surgery

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