title: Prophylactic antibiotics cannot reduce infected pancreatic necrosis and mortality in acute necrotizing pancreatitis: evidence from a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  There is no agreement whether intravenous prophylactic antibiotics can reduce infected pancreatic necrosis and mortality in acute necrotizing pancreatitis (ANP). We performed a meta-analysis comparing intravenous antibiotics with placebo or no treatment in randomized controlled trials (RCTs).
  
  
  METHODS
  Databases including MEDLINE, EMBASE, the Cochrane controlled trials register, the Cochrane Library, and Science Citation Index were searched to find relevant trials. Outcome measures were infected necrosis and mortality.
  
  
  RESULTS
  Seven trials involving 467 patients were included. Analysis suggested infected pancreatic necrosis rates were not significantly different (antibiotics 17.8%, controls 22.9%), RR 0.81 (95% CI 0.54-1.22). There was nonsignificantly decreased mortality with antibiotics (9.3%) versus controls (15.2%), RR 0.70 (95% CI 0.42-1.17). Subsequent subgroup analysis confirmed antibiotics were not statistically superior to controls in reduction of infected necrosis and mortality.
  
  
  CONCLUSIONS
  Prophylactic antibiotics cannot reduce infected pancreatic necrosis and mortality in patients with ANP.
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Bai
authors.forename: Jun
authors.initials: J
authors.lastname: Gao
authors.forename: Duo-Wu
authors.initials: DW
authors.lastname: Zou
authors.forename: Zhao-Shen
authors.initials: ZS
authors.lastname: Li
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001424:Bacterial Infections / Q000150:complications / Q000517:prevention & control*; D018450:Disease Progression; D006801:Humans; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000401:mortality* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents