title: Role of antibiotic prophylaxis in necrotizing pancreatitis: a meta-analysis.
abstract: Several studies have yielded conflicting results on the role of antibiotic prophylaxis in improving outcomes in acute necrotizing pancreatitis. A meta-analysis was carried out to investigate the impact of antibiotic prophylaxis in the incidence of infected pancreatic necrosis and mortality.
  
  
  METHODS
  Randomized controlled trials and cohort studies investigating impact of prophylactic systemic antibiotic used in acute necrotizing pancreatitis were retrieved from online databases. An overall analysis was done with all studies (Group 1), followed by subgroup analyses with randomized controlled trials (Group 2) and cohort studies (Group 3). Risk ratios (RR) were calculated for the impact of antibiotic prophylaxis in the incidence of infected pancreatic necrosis and mortality in each group using random effects model.
  
  
  RESULTS
  Eleven studies involving 864 patients were included. No significant differences in the incidence of infected pancreatic necrosis were observed with prophylactic antibiotic use in all groups. Prophylactic antibiotic use was not associated with significant differences in all-cause mortality in Group 2 (RR = 0.75; p = 0.24) but was associated with a reduction in Groups 1 (RR = 0.66, p = 0.02) and 3 (RR = 0.55, p = 0.04). There was no statistical difference in the incidence of fungal infections and surgical interventions.
  
  
  CONCLUSIONS
  Antibiotic prophylaxis does not significantly reduce the incidence of infected pancreatic necrosis but may affect all-cause mortality in acute necrotizing pancreatitis.
authors.affiliation: Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
authors.forename: Cheryl Li Ling
authors.initials: CL
authors.lastname: Lim
authors.forename: Winnie
authors.initials: W
authors.lastname: Lee
authors.forename: Yi Xin
authors.initials: YX
authors.lastname: Liew
authors.forename: Sarah Si Lin
authors.initials: SS
authors.lastname: Tang
authors.forename: Maciej Piotr
authors.initials: MP
authors.lastname: Chlebicki
authors.forename: Andrea Lay-Hoon
authors.initials: AL
authors.lastname: Kwa
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002423:Cause of Death; D006801:Humans; D015994:Incidence; D059413:Intraabdominal Infections / Q000453:epidemiology* / Q000517:prevention & control* / Q000601:surgery; D009181:Mycoses / Q000453:epidemiology; D016017:Odds Ratio; D019283:Pancreatitis, Acute Necrotizing / Q000401:mortality* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents