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Systematic review and meta-analysis of antibiotic prophylaxis in severe acute pancreatitis
- Source :
- Scandinavian Journal of Gastroenterology. 46:261-270
- Publication Year :
- 2010
- Publisher :
- Informa UK Limited, 2010.
-
Abstract
- The incidence of acute pancreatitis varies from 5 to 80 per 100,000 throughout the world. The most common cause of death in these patients is infection of pancreatic necrosis by enteric bacteria, spurring the discussion of whether or not prophylactic antibiotic administration could be a beneficial approach. In order to provide evidence of the effect of antibiotic prophylaxis in severe acute pancreatitis (SAP) we performed an updated systematic review and meta-analysis on this topic.The review of randomized controlled trials was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. We conducted a search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. For assessment of the treatment effects we calculated the risk ratios (RRs) for dichotomous data of included studies.Fourteen trials were included with a total of 841 patients. The use of antibiotic prophylaxis was not associated with a statistically significant reduction in mortality (RR 0.74 [95% CI 0.50-1.07]), in the incidence of infected pancreatic necrosis (RR 0.78 [95% CI 0.60-1.02]), in the incidence of non-pancreatic infections (RR 0.70 [95% CI 0.46-1.06]), and in surgical interventions (RR 0.93 [95% CI 0.72-1.20]).In summary, to date there is no evidence that supports the routine use of antibiotic prophylaxis in patients with SAP.
- Subjects :
- medicine.medical_specialty
Pancreatitis, Acute Necrotizing
business.industry
Enterobacteriaceae Infections
Gastroenterology
MEDLINE
Antibiotic Prophylaxis
medicine.disease
Anti-Bacterial Agents
law.invention
Clinical trial
Systematic review
Pancreatitis
Randomized controlled trial
law
Meta-analysis
Acute Disease
Odds Ratio
medicine
Humans
Acute pancreatitis
Antibiotic prophylaxis
Intensive care medicine
business
Subjects
Details
- ISSN :
- 15027708 and 00365521
- Volume :
- 46
- Database :
- OpenAIRE
- Journal :
- Scandinavian Journal of Gastroenterology
- Accession number :
- edsair.doi.dedup.....16dad115d55bb68e453e4975fd9c16f2
- Full Text :
- https://doi.org/10.3109/00365521.2010.531486