ArticleCritical care (London, England)2008
Prophylactic antibiotic treatment is superior to therapy on-demand in experimental necrotising pancreatitis.
Article in Critical care (London, England), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 23 citations in OpenAlex.
- A Randomized Phase II Study to Evaluate Prolonged Prophylactic Antibacterial Drug Treatment for Patients with Elevated Drain Amylase Concentration After Gastrectomy with D2 Lymph Node Dissection (REDUCED2).World journal of surgery · 2021Trial
- The Roles of Gut Microbiota in the Pathogenesis of Acute Pancreatitis.Medical science monitor : international medical journal of experimental and clinical research · 2026Review
- Usefulness of Bacterial Culture of Drainage Fluid for Predicting Surgical Site Infection After Crohn's Disease Surgery.Annals of gastroenterological surgery · 2022Article
- NLRP3 Inflammasome-Mediated Inflammation in Acute Pancreatitis.International journal of molecular sciences · 2020Review
- Two-point measurement of amylase in drainage fluid predicts severe postoperative pancreatic fistula after gastric cancer surgery.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2018Article
- Nucleotide-binding oligomerization domain 1 and gastrointestinal disorders.Proceedings of the Japan Academy. Series B, Physical and biological sciences · 2017Review
- Antibiotic-Induced Pathobiont Dissemination Accelerates Mortality in Severe Experimental Pancreatitis.Frontiers in immunology · 2017Article
- Paeoniflorin ameliorates acute necrotizing pancreatitis and pancreatitis‑induced acute renal injury.Molecular medicine reports · 2016Article
- Enzymatic debridement in necrotizing pancreatitis.International surgery · 2015Article
- Effects of prophylactic antibiotics in acute pancreatitis.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2012Article
- Effect of octreotide on enteric motor neurons in experimental acute necrotizing pancreatitis.PloS one · 2012Article
- [Diagnosis and treatment of acute pancreatitis. Current recommendations].Der Internist · 2011Article
- A role for prophylactic antibiotics in necrotizing pancreatitis? Why we may never know the answer ...Critical care (London, England) · 2008Article
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9 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionHigh morbidity and mortality rates in patients with severe acute pancreatitis are mainly caused by bacterial superinfection of pancreatic necrosis and subsequent sepsis. The benefit of early prophylactic antibiotics remains controversial because clinical studies performed to date were statistically underpowered. Thus, the aim of this study was to evaluate on-demand versus prophylactic antibiotic treatment in a standardised experimental model.
methodsTreatment groups received meropenem either therapeutically 24 hours after induction of necrotising pancreatitis or prophylactically before development of pancreatic superinfection. At 24 and 72 hours, pancreatic injury was investigated by histology and translocation by bacterial cultures of pancreatic tissue and mesenteric lymph nodes. Septic complications were evaluated by blood cultures and survival.
resultsWithout antibiotic treatment, pancreatic superinfection was observed in almost all cases after induction of necrotising pancreatitis. The 72-hour-mortality rate was 42.9% and bacterial infection of mesenteric lymph nodes and bacteraemia was found in 87.5% of the surviving animals. Therapeutic administration of meropenem on-demand reduced bacteraemia to 50% and mortality to 27.3%. However, prophylactic antibiotic treatment significantly reduced bacteraemia to 25.0% (p = 0.04) and pancreatic superinfection as well as mortality to 0% (p < 0.001 and p = 0.05, respectively) compared with controls.
conclusionsIn the present study both prophylactic and delayed antibiotic treatment on-demand reduced septic complications in a standardised setting of experimental necrotising pancreatitis. However, pancreatic superinfection, bacteraemia and mortality rates were reduced significantly by early treatment. Thus, in the absence of statistically relevant and well-designed clinical trials, the study demonstrates that prophylactic antibiotic treatment is superior to antibiotic treatment on-demand.
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