Engelsk titel: Antibiotic prophylaxis in acute pancreatitis - is the evidence good enough?
Läs online
Författare:
Fretland ÅA
Email: aasmund@fretland.no
Språk: Nor
Antal referenser: 24
Dokumenttyp:
Översikt
UI-nummer: 05051844
Sammanfattning
BACKGROUND : Randomized controlled trials on acute necrotizing pancreatitis suggest that prophylactic antibiotics can reduce mortality and morbidity in these patients by preventing pancreatic infections.
MATERIAL AND METHOD : Relevant articles were assessed using a clinical appraisal skills programme.
INTERPRETATION : Based on the results obtained so far, the evidence is not yet strong enough to recommend prophylactic antibiotics in acute necrotizing pancreatitis. There is still a need for a new, larger, multicentre study that pays careful attention to all aspects of the condition, for instance diagnosis and treatment of abdominal compartment syndrome, and guidelines for method and time of surgery.
RESULTS : Eight trials have been published since 1990. The early trials showed that prophylactic antibiotics did reduce mortality and morbidity; however, errors of methodology weaken these results. In later trials results have varied: in September 2004, Isenmann et al. published a trial with a greatly improved design and found no effect of prophylactic antibiotics compared to antibiotic treatment on demand.