The use of antibiotic prophylaxis in necrotizing pancreatitis remains controversial.
In this study, physicians from Germany assessed whether antibiotic prophylaxis reduced the proportion of patients who developed infected pancreatic necrosis.
|Mortality was 5% in the antibiotic group and 7% in the placebo group.|
The team enrolled 114 patients with acute pancreatitis in combination with a serum C-reactive protein exceeding 150 mg/L and/or necrosis on contrast-enhanced CT scan.
Patients received either intravenous ciprofloxacin (CIP) (2 x 400 mg per day) plus metronidazole (MET) (2 x 500 mg per day) or placebo.
The study medication was discontinued and patients switched to open antibiotic treatment if infectious complications, multiple organ failure sepsis, or systemic inflammatory response syndrome (SIRS) occurred.
The physicians found that 28% of patients in the CIP/MET group required open antibiotic treatment, compared with 46% in the placebo group.
Furthermore, 12% of the CIP/MET group developed infected pancreatic necrosis compared with 9% of the placebo group.
The team found that mortality was 5% in the CIP/MET and 7% in the placebo group.
They did not find any differences in the rate of infected pancreatic necrosis, systemic complications, or mortality between the 2 groups.
Dr Rainer Isenmann and colleagues concluded, "This study detected no benefit of antibiotic prophylaxis with respect to the risk of developing infected pancreatic necrosis".