Questions about the use of antibiotics in acute pancreatitis.
OBJECTIVE
The use of antibiotics in acute pancreatitis despite recent clinical trials remains controversial. The aim of this study is to review the latest clinical trials and guidelines about antibiotics in acute pancreatitis and determine its proper use.


METHODS
Through a Medline search, we selected and analyzed pertinent randomized clinical trials and guidelines that evaluated the use of antibiotics in acute pancreatitis. We answered the most frequent questions about this topic.


CONCLUSIONS
Based on these clinical trials and guidelines, we conclude that the best treatment currently is the use of antibiotics in patients with severe acute pancreatitis with more than 30% of pancreatic necrosis. The best option for the treatment is Imipenem 3 x 500 mg/day i.v. for 14 days. Alternatively, Ciprofloxacin 2 x 400 mg/day i.v. associated with Metronidazole 3 x 500 mg for 14 days can also be considered as an option.
De Campos
Tercio
T
Emergency Surgery Unit, Santa Casa School of Medical Sciences, São Paulo, Brazil. tercio@uol.com.br
Assef
Jose Cesar
JC
Rasslan
Samir
S