M. Nazim Khan.
Antibiotic prophylaxis in severe acute pancreatitis.
Fauji Found Health J Jan ;1(2):2-6.

Infectious complications are a common diagnostic and therapeutic problem in severe acute pancreatitis. The close association between infection and poor outcome in severe pancreatitis has led many investigators to hypothesize that intravenous antibiotic prophylaxis might reduce infection and thereby reduce mortality. The results of three prospective randomized clinical studies of antibiotic prophylaxis in severe acute pancreatitis provide evidence of a role for antimicrobial therapy as part of initial treatment in this condition. Selective gut decontamination with oral antibiotics is an alternative strategy aimed at eliminating pathogenic intestinal flora to reduce bacterial translocation, thereby, reducing the risk of pancreatic infection. However, the role of antibiotic prophylaxis in the initial management of patients with acute pancreatitis is ,still controversial, as to date, no large scale prospective study of sufficient sample power makes the use of antibiotic prophylaxis mandatory. Recently a significant body of clinicians is using antibiotic prophylaxis in the initial management of patients with predicted severe acute pancreatitis in the UK and Ireland. The recent evidence suggests a benefi t from the use of prophylactic antibiotics in prognostically severe acute pancreatitis. Therefore, use of prophylactic antibiotic in the early management of severe acute pancreatitis is highly recommended.

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