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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Meta-analysis of prophylactic parenteral antibiotic use in acute necrotizing pancreatitis

1
Department of Surgery
2
Institute for Biomedical Research, Kaunas University of Medicine, Lithuania
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Author to whom correspondence should be addressed.
Medicina 2007, 43(4), 291; https://doi.org/10.3390/medicina43040036
Received: 18 July 2006 / Accepted: 5 April 2007 / Published: 10 April 2007
Background. Acute pancreatitis is a potentially serious condition. It carries an overall mortality rate of 10–15%. Infectious complications account for approximately 80% of deaths from acute pancreatitis, and the question arises whether or not prophylactic antibiotics are useful in the prevention of these complications. Therefore, we performed an evidence-based analysis to assess the effect of available prophylactic antimicrobial treatment on the development of infected necrosis and sepsis, need for surgery, and mortality.
Methods
. A comprehensive PubMed search was performed evaluating the value of prophylactic administration of parenteral antibiotics in patients with acute necrotizing pancreatitis. Only articles published in English language between January 1990 and May 2006 were included. The search strategy initially generated 692 articles related to antibiotics in the treatment of acute pancreatitis. This number was reduced to 97 publications related to clinical trials on the same topic. Finally, 10 randomized clinical trials concerning prophylactic parenteral antibiotics in patients with acute necrotizing pancreatitis were identified. We have performed a meta-analysis using the random-effects model to assess the impact of prophylactic antibiotics on development of infected pancreatic necrosis and sepsis, need for surgery, and overall mortality.
Results
. Patients with necrotizing acute pancreatitis should receive effective antibiotic prophylaxis (i.e., carbapenems intravenously) to decrease the risk of infected necrosis and sepsis and need of surgery.
Conclusions
. While providing new insights into key aspects of antibiotic prophylaxis, this evidence-based analysis highlights the need for further clinical trials regarding the indications for antibiotic prophylaxis.
Keywords: acute necrotizing pancreatitis; infected necrosis; antibiotic prophylaxis; metaanalysis acute necrotizing pancreatitis; infected necrosis; antibiotic prophylaxis; metaanalysis
MDPI and ACS Style

Dambrauskas, Ž.; Gulbinas, A.; Pundzius, J.; Barauskas, G. Meta-analysis of prophylactic parenteral antibiotic use in acute necrotizing pancreatitis. Medicina 2007, 43, 291.

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