TY - JOUR
T1 - Prophylaxis for septic complications in acute necrotizing pancreatitis
AU - Bassi, Claudio
AU - Mangiante, Gerardo
AU - Falconi, Massimo
AU - Salvia, Roberto
AU - Frigerio, Isabella
AU - Pederzoli, Paolo
PY - 2001
Y1 - 2001
N2 - 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.
AB - 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.
KW - Acute pancreatitis
KW - Antibiotics
KW - Enteral nutrition
KW - Infected pancreatic necrosis
KW - Pancreatic abscess
UR - http://www.scopus.com/inward/record.url?scp=0035229863&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035229863&partnerID=8YFLogxK
U2 - 10.1007/s005340170018
DO - 10.1007/s005340170018
M3 - Article
C2 - 11455481
AN - SCOPUS:0035229863
VL - 8
SP - 211
EP - 215
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
SN - 0944-1166
IS - 3
ER -