Role of antibiotic prophylaxis in necrotizing pancreatitis: a meta-analysis.

Abstract

UNLABELLED:

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.

METHODOLOGY:

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.

CONCLUSION:

Antibiotic prophylaxis does not significantly reduce the incidence of infected pancreatic necrosis but may affect all-cause mortality in acute necrotizing pancreatitis.

• Authors: Cheryl Li Ling Lim, Winnie Lee, Yi Xin Liew, Sarah Si Lin Tang, Maciej Piotr Chlebicki, Andrea Lay-Hoon Kwa
• Journal: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (J Gastrointest Surg) Vol. 19 Issue 3 Pg. 480-91 (Mar 2015) ISSN: 1873-4626 [Electronic] United States
• PMID: 25608671 (Publication Type: Journal Article, Meta-Analysis, Review)

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (therapeutic use)
• Antibiotic Prophylaxis
• Cause of Death
• Humans
• Incidence
• Intraabdominal Infections (epidemiology, prevention & control, surgery)
• Mycoses (epidemiology)
• Odds Ratio
• Pancreatitis, Acute Necrotizing (mortality, surgery)