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Prophylactic antibiotics in acute pancreatitis: endless debate (Record no. 76121)

MARC details
000 -LEADER
fixed length control field 02430cam a2200169 4500
001 - CONTROL NUMBER
control field NMDX7125
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 120401t2016 xxu||||| |||| 00| 0 eng d
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Kalidindi, V
240 ## - UNIFORM TITLE
Uniform title <a href="Annals of the Royal College of Surgeons of England">Annals of the Royal College of Surgeons of England</a>
245 ## - TITLE STATEMENT
Title Prophylactic antibiotics in acute pancreatitis: endless debate
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT)
Date of publication, distribution, etc. 2016
500 ## - GENERAL NOTE
General note NMUH Staff Publications
520 ## - SUMMARY, ETC.
Summary, etc. &lt;span style="font-size: 10pt;"&gt;INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis. RESULTS Mixed evidence was found to support and refute the role of prophylactic antibiotics in acute pancreatitis. Most studies have failed to demonstrate much benefit from its routine use. Data from our unit suggested little benefit of their routine use, and showed that the mortality of those treated with antibiotics was significantly higher compared with those not treated with antibiotics (9% vs 0%, respectively, P&amp;nbsp;=&amp;nbsp;0.043). In addition, the antibiotic group had significantly higher morbidity (36% vs 5%, respectively, P&amp;nbsp;=&amp;nbsp;0.002). CONCLUSIONS Antibiotics should be used in patients who develop sepsis, infected necrosis-related systemic inflammatory response syndrome, multiple organ dysfunction syndrome or pancreatic and extra-pancreatic infection. Despite the many other factors that should be considered, prompt antibiotic therapy is recommended once inflammatory markers are raised, to prevent secondary pancreatic infection. Unfortunately, there remain many unanswered questions regarding the indications for antibiotic administration and the patients who benefit from antibiotic treatment in acute pancreatitis.&lt;/span&gt;
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Dvorkin, L.
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="https://www.ncbi.nlm.nih.gov/pubmed/27917667">https://www.ncbi.nlm.nih.gov/pubmed/27917667</a>
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="http://publishing.rcseng.ac.uk/doi/pdf/10.1308/rcsann.2016.0355">http://publishing.rcseng.ac.uk/doi/pdf/10.1308/rcsann.2016.0355</a>
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        Staff publications for NMDX Ferriman Information and Library Service (North Middlesex) Ferriman Information and Library Service (North Middlesex) Online 07/06/2022   07/06/2022 07/06/2022 UNKNOWN