[Rational use of antibiotics in severe acute pancreatitis:controversy and progress]

Zhonghua Yi Xue Za Zhi. 2021 Aug 10;101(30):2346-2348. doi: 10.3760/cma.j.cn112137-20210307-00580.
[Article in Chinese]

Abstract

Infection of pancreatic necrosis is the most frequent cause of late mortality in severe acute pancreatitis(SAP). Most clinical guidelines of acute pancreatitis recommended that prophylactic antibiotics should be avoided. Prophylactic antibiotics can not reduce the pancreatic infection rate or mortality in patients with SAP ornecrotizing pancreatitis. Definitive infection is the only indication for rational use of antibiotics in SAP patients. Broad-spectrum antibiotics for treatment should cover enteric bacteria, and the bacteriology and antibiotic pharmacokinetics of SAP should be considered when selecting antibiotics.

胰腺坏死感染是重症急性胰腺炎(SAP)常见的后期死亡原因。多数急性胰腺炎临床指南建议避免使用预防性抗生素,预防性抗生素不能降低SAP或坏死性胰腺炎患者的感染率或死亡率。而确定性感染是SAP患者合理使用抗生素的唯一适应证,治疗用广谱抗生素应覆盖肠道细菌,选择抗生素应该考虑SAP的细菌学及抗生素药代动力学。.

MeSH terms

  • Acute Disease
  • Anti-Bacterial Agents* / therapeutic use
  • Antibiotic Prophylaxis
  • Humans
  • Pancreatitis, Acute Necrotizing* / drug therapy

Substances

  • Anti-Bacterial Agents