The effect of prophylactic antibiotic treatment on infection and survival of acute necrotizing pancreatitis remains uncertain.
Drs Tao Xu and Qingping Cai from China assessed the long-term efficacy of prophylactic antibiotic treatment for acute necrotizing pancreatitis.
The research team conducted a meta-analysis of all randomized controlled trials comparing prophylactic antibiotic treatment with placebo or no treatment was performed.
Searches were carried out in 2007 of electronic databases including Medline, EMBASE, the Cochrane Controlled Trials Register, the Science Citation Index, and PubMed.
Manual bibliographical searches were also conducted.
|Carbapenem was associated with a significant reduction in infected necrosis|
|Scandanavian Journal of Gastroenterology|
The researchers assessed 8 randomized controlled trials including 540 patients.
The outcomes included infected necrosis, death, non-pancreatic infection, surgical intervention, and length of hospital stay.
The team noted that prophylactic antibiotic use leads to a significant reduction of infected necrosis, non-pancreatic infections, and length of hospital stay.
However, prophylactic antibiotic use was not associated with a statistically significant reduction in mortality and surgical intervention.
In a subgroup analysis, carbapenem was associated with a significant reduction in infected necrosis and non-pancreatic infections, whereas other antibiotics were not.
Dr Xu and colleague concludes, “Prophylactic antibiotic treatment is associated with a significant reduction of pancreatic or peripancreatic infection.”
“Non-pancreatic infection, and length of hospital stay, but cannot prevent death and surgical intervention in acute necrotizing pancreatitis.”