Document Detail


Prophylactic antibiotic treatment in acute necrotizing pancreatitis: results from a meta-analysis.
MedLine Citation:
PMID:  18609129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The effect of prophylactic antibiotic treatment on infection and survival of acute necrotizing pancreatitis (ANP) remains uncertain. The aim of this study was to assess the long-term efficacy of prophylactic antibiotic treatment for ANP. MATERIAL AND METHODS: Searches were carried out of electronic databases including Medline, EMBASE, the Cochrane Controlled Trials Register, the Science Citation Index, and PubMed (updated to December 2007), and manual bibliographical searches were also conducted. A meta-analysis of all randomized controlled trials (RCTs) comparing prophylactic antibiotic treatment with placebo or no treatment was performed. RESULTS: Eight RCTs including 540 patients were assessed. The outcomes included infected necrosis, death, non-pancreatic infection, surgical intervention, and length of hospital stay. Prophylactic antibiotic use leads to a significant reduction of infected necrosis (relative risk (RR) 0.69, 95% CI, 0.50-0.95; p=0.02), non-pancreatic infections (RR 0.66 95% CI, 0.48-0.91; p=0.01), and length of hospital stay (p=0.004) but was not associated with a statistically significant reduction in mortality (RR 0.76 95% CI, 0.50-1.18; p=0.22) and surgical intervention (RR 0.90 95% CI, 0.66-1.23; p=0.52). In a subgroup analysis, carbapenem was associated with a significant reduction in infected necrosis (p=0.009) and non-pancreatic infections (p=0.006), whereas other antibiotics were not. CONCLUSIONS: 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.
Authors:
Tao Xu; Qingping Cai
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  43     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2008  
Date Detail:
Created Date:  2008-09-19     Completed Date:  2009-02-06     Revised Date:  2009-04-27    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  1249-58     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use*
Antibiotic Prophylaxis
Bacterial Infections / complications,  prevention & control*
Female
Humans
Male
Pancreatitis, Acute Necrotizing / drug therapy*,  mortality*
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections
Comment In:
Scand J Gastroenterol. 2009;44(5):637-8; author reply 639-40   [PMID:  18815941 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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