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Published in: World Journal of Emergency Surgery 1/2006

Open Access 01-12-2006 | Review

Questions about the use of antibiotics in acute pancreatitis

Authors: Tercio De Campos, Jose Cesar Assef, Samir Rasslan

Published in: World Journal of Emergency Surgery | Issue 1/2006

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Abstract

Background and objective

The use of antibiotics in acute pancreatitis despite recent clinical trials remains controversial. The aim of this study is to review the latest clinical trials and guidelines about antibiotics in acute pancreatitis and determine its proper use.

Methods

Through a Medline search, we selected and analyzed pertinent randomized clinical trials and guidelines that evaluated the use of antibiotics in acute pancreatitis. We answered the most frequent questions about this topic.

Results and conclusion

Based on these clinical trials and guidelines, we conclude that the best treatment currently is the use of antibiotics in patients with severe acute pancreatitis with more than 30% of pancreatic necrosis. The best option for the treatment is Imipenem 3 × 500 mg/day i.v. for 14 days. Alternatively, Ciprofloxacin 2 × 400 mg/day i.v. associated with Metronidazole 3 × 500 mg for 14 days can also be considered as an option.
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Metadata
Title
Questions about the use of antibiotics in acute pancreatitis
Authors
Tercio De Campos
Jose Cesar Assef
Samir Rasslan
Publication date
01-12-2006
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2006
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/1749-7922-1-20

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