Antibiotic prophylaxis in the initial management of severe acute pancreatitis.
BACKGROUND
The role of antibiotic prophylaxis in the initial management of patients with acute pancreatitis is an area of major controversy. Contrary to earlier clinical trials, recent experimental and clinical studies have accrued evidence that warrants reappraisal of current clinical practice. This article reviews these recent advances in knowledge.


METHODS
All papers derived from a Medline search for the years 1990-1997 inclusive using the text words 'acute', 'pancreatitis', 'antibiotic' and 'antibiotics' were studied. Additional papers were derived from reference lists within papers identified by the Medline search. Only experimental and clinical papers relevant to the issue of prophylactic antibiotic therapy in acute pancreatitis are included in the review.


CONCLUSIONS
Current experimental evidence favours the use of prophylactic antibiotics in severe acute pancreatitis. The results of contemporary randomized clinical trials restricted to patients with prognostically severe acute pancreatitis have demonstrated improvement in outcome associated with antibiotic treatment.
Powell
J J
JJ
University Department of Surgery, Royal Infirmary of Edinburgh, UK.
Miles
R
R
Siriwardena
A K
AK
D000208:Acute Disease; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001424:Bacterial Infections / Q000517:prevention & control*; D018849:Controlled Clinical Trials as Topic; D003657:Decision Making; D006801:Humans; D007262:Infusions, Intravenous; D010195:Pancreatitis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents