Abstract
OBJECTIVES: Antibiotic prophylaxis improves the outcome of acute pancreatitis. Since bacterial translocation from the gut occurs in the first h of disease, early therapy is likely to achieve the maximal effect. The study compares early antibiotic treatment with treatment started after the demonstration of pancreatic necrosis. METHODS: Two hundred fifteen patients with pancreatitis were randomized to either group A (N = 108), who started antibiotic therapy (meropenem 500 mg t.i.d.) at admission, or group B (N = 107), who received antibiotics after the demonstration of necrosis at computed tomography (CT). CT was performed in both groups after at least 48 hr of hospitalization. The clinical course of disease was compared in the two groups. RESULTS: Thirty patients in group A and 29 in B showed necrosis on CT. The two groups were similar in demographics and characteristics of disease. Antibiotic treatment was started after 4.56 ± 1.2 days from hospitalization in group B and after 1.07 ± 0.6 days in A. Pancreatic infection occurred in four patients in group A (13.3%) and in nine in B (31%) (p = 0.1). Extrapancreatic infection occurred in 16.6% of patients in group A and in 44.8% in B (p <0.05). Need for surgery and length of hospitalization were also higher in group B. Mortality rates were similar in the two groups, but, 3 of 4 patients with infected necrosis in group A and only 2 of 9 in group B died. CONCLUSIONS: Early antibiotic treatment is associated with a significant improvement in the prognosis of necrotizing acute pancreatitis (AP), because of a reduction in the occurrence of septic complications.
| Original language | English |
|---|---|
| Pages (from-to) | 1348-1353 |
| Number of pages | 6 |
| Journal | American Journal of Gastroenterology |
| Volume | 101 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2006 |
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ASJC Scopus subject areas
- Gastroenterology
Cite this
Timing of antibiotic prophylaxis in acute pancreatitis : A controlled randomized study with meropenem. / Manes, Gianpiero; Uomo, Ilaria; Menchise, Antonella; Rabitti, Pier Giorgio; Ferrara, Elisa Chiara; Uomo, Generoso.
In: American Journal of Gastroenterology, Vol. 101, No. 6, 06.2006, p. 1348-1353.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Timing of antibiotic prophylaxis in acute pancreatitis
T2 - A controlled randomized study with meropenem
AU - Manes, Gianpiero
AU - Uomo, Ilaria
AU - Menchise, Antonella
AU - Rabitti, Pier Giorgio
AU - Ferrara, Elisa Chiara
AU - Uomo, Generoso
PY - 2006/6
Y1 - 2006/6
N2 - OBJECTIVES: Antibiotic prophylaxis improves the outcome of acute pancreatitis. Since bacterial translocation from the gut occurs in the first h of disease, early therapy is likely to achieve the maximal effect. The study compares early antibiotic treatment with treatment started after the demonstration of pancreatic necrosis. METHODS: Two hundred fifteen patients with pancreatitis were randomized to either group A (N = 108), who started antibiotic therapy (meropenem 500 mg t.i.d.) at admission, or group B (N = 107), who received antibiotics after the demonstration of necrosis at computed tomography (CT). CT was performed in both groups after at least 48 hr of hospitalization. The clinical course of disease was compared in the two groups. RESULTS: Thirty patients in group A and 29 in B showed necrosis on CT. The two groups were similar in demographics and characteristics of disease. Antibiotic treatment was started after 4.56 ± 1.2 days from hospitalization in group B and after 1.07 ± 0.6 days in A. Pancreatic infection occurred in four patients in group A (13.3%) and in nine in B (31%) (p = 0.1). Extrapancreatic infection occurred in 16.6% of patients in group A and in 44.8% in B (p <0.05). Need for surgery and length of hospitalization were also higher in group B. Mortality rates were similar in the two groups, but, 3 of 4 patients with infected necrosis in group A and only 2 of 9 in group B died. CONCLUSIONS: Early antibiotic treatment is associated with a significant improvement in the prognosis of necrotizing acute pancreatitis (AP), because of a reduction in the occurrence of septic complications.
AB - OBJECTIVES: Antibiotic prophylaxis improves the outcome of acute pancreatitis. Since bacterial translocation from the gut occurs in the first h of disease, early therapy is likely to achieve the maximal effect. The study compares early antibiotic treatment with treatment started after the demonstration of pancreatic necrosis. METHODS: Two hundred fifteen patients with pancreatitis were randomized to either group A (N = 108), who started antibiotic therapy (meropenem 500 mg t.i.d.) at admission, or group B (N = 107), who received antibiotics after the demonstration of necrosis at computed tomography (CT). CT was performed in both groups after at least 48 hr of hospitalization. The clinical course of disease was compared in the two groups. RESULTS: Thirty patients in group A and 29 in B showed necrosis on CT. The two groups were similar in demographics and characteristics of disease. Antibiotic treatment was started after 4.56 ± 1.2 days from hospitalization in group B and after 1.07 ± 0.6 days in A. Pancreatic infection occurred in four patients in group A (13.3%) and in nine in B (31%) (p = 0.1). Extrapancreatic infection occurred in 16.6% of patients in group A and in 44.8% in B (p <0.05). Need for surgery and length of hospitalization were also higher in group B. Mortality rates were similar in the two groups, but, 3 of 4 patients with infected necrosis in group A and only 2 of 9 in group B died. CONCLUSIONS: Early antibiotic treatment is associated with a significant improvement in the prognosis of necrotizing acute pancreatitis (AP), because of a reduction in the occurrence of septic complications.
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U2 - 10.1111/j.1572-0241.2006.00567.x
DO - 10.1111/j.1572-0241.2006.00567.x
M3 - Article
VL - 101
SP - 1348
EP - 1353
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 6
ER -