Prophylactic antibiotics in necrotizing pancreatitis: a meta-analysis.
OBJECTIVE
Prophylactic antibiotics have been used in acute necrotizing pancreatitis with mixed results. This meta-analysis analyzes the effects of prophylactic antibiotics in necrotizing pancreatitis.


METHODS
Multiple databases and abstracts were searched for randomized trials comparing treatment with prophylactic antibiotics to treatment without prophylactic antibiotics in necrotizing pancreatitis. Prophylactic antibiotics' effects were analyzed by calculating pooled estimates of mortality, infected pancreatic necrosis, length of hospital stay, nonpancreatic infections, and surgical intervention.


RESULTS
Seven studies (n = 429) met the inclusion criteria. Prophylactic antibiotics for acute necrotizing pancreatitis significantly decreased the length of hospital stay (P = 0.04) and the rate of nonpancreatic infections (P < 0.01). No significant differences were noted for mortality (P = 0.22), infected necrosis (P = 0.18), and surgical intervention (P = 0.40).


CONCLUSIONS
Prophylactic antibiotics in necrotizing pancreatitis reduced the length of hospital stay and rate of nonpancreatic infections but did not decrease mortality, infected necrosis, or surgical intervention.
Hart
Phil A
PA
Division of Gastroenterology, University of Missouri School of Medicine, Columbia, MO 65212, USA.
Bechtold
Matthew L
ML
Marshall
John B
JB
Choudhary
Abhishek
A
Puli
Srinivas R
SR
Roy
Praveen K
PK
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D006801:Humans; D007902:Length of Stay; D015337:Multicenter Studies as Topic; D019283:Pancreatitis, Acute Necrotizing / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic
D000900:Anti-Bacterial Agents