Infectious complications, prognostic factors and assessment of anti-infectious management of 212 consecutive patients with acute pancreatitis.
OBJECTIVE
Acute pancreatitis is an important cause of morbidity and mortality, mainly due to sepsis. The aim of this study was to determine the incidence of infectious complications and their impact on mortality in patients hospitalized for acute pancreatitis.


METHODS
Patients admitted for acute pancreatitis were retrospectively included within a period between 1995 and 2000. Incidence of abdominal and extra-abdominal sepsis and specific care were specifically analyzed. Risk factors for death were evaluated by uni- and multivariated analysis.


RESULTS
Two hundreds and twelve consecutive patients (128 males, median age 54 years) were included. Mortality was 10.8%. At least one infectious episode was collected in 25% of the patients with an abdominal sepsis (26.8%), bacteriemia (24.4%), respiratory (24.4%) and urinary tracts (19.5%) infections. Infection was polymicrobial in 37.5%. An antibiotic prophylaxis was administered in 10.8%, more often in patients with severe pancreatitis. It did not alter mortality or incidence of infections but significantly delayed occurrence of sepsis. Mortality of patients treated with more than one line of antibiotics was higher. However in this study infectious complications were not an independent factor for mortality.


CONCLUSIONS
Infections are frequent and polymicrobial but are not an independent prognostic factor during acute pancreatitis.
Bourgaux
Jean-François
JF
Hepato-Gastroenterology, Nimes University Hospital, France. jean-francois-bourgaux@chu-nimes.fr
Defez
Christine
C
Muller
Laurent
L
Vivancos
Julien
J
Prudhomme
Michel
M
Navarro
Francis
F
Pouderoux
Philippe
P
Sotto
Albert
A
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology; D013997:Time Factors
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D000658:Amoxicillin; D017963:Azithromycin