title: Infectious complications, prognostic factors and assessment of anti-infectious management of 212 consecutive patients with acute pancreatitis.
abstract: 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.
authors.affiliation: Hepato-Gastroenterology, Nimes University Hospital, France. jean-francois-bourgaux@chu-nimes.fr
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bourgaux
authors.forename: Christine
authors.initials: C
authors.lastname: Defez
authors.forename: Laurent
authors.initials: L
authors.lastname: Muller
authors.forename: Julien
authors.initials: J
authors.lastname: Vivancos
authors.forename: Michel
authors.initials: M
authors.lastname: Prudhomme
authors.forename: Francis
authors.initials: F
authors.lastname: Navarro
authors.forename: Philippe
authors.initials: P
authors.lastname: Pouderoux
authors.forename: Albert
authors.initials: A
authors.lastname: Sotto
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D000658:Amoxicillin; D017963:Azithromycin