Version 1
: Received: 22 August 2024 / Approved: 22 August 2024 / Online: 23 August 2024 (11:39:32 CEST)
How to cite:
Badia, J. M.; Amador, S.; González-Sánchez, C.; Rubio-Pérez, I.; Manuel-Vázquez, A.; Juvany, M.; Membrilla, E.; Balibrea, J. M.; Guirao, X. Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review. Preprints2024, 2024081669. https://doi.org/10.20944/preprints202408.1669.v1
Badia, J. M.; Amador, S.; González-Sánchez, C.; Rubio-Pérez, I.; Manuel-Vázquez, A.; Juvany, M.; Membrilla, E.; Balibrea, J. M.; Guirao, X. Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review. Preprints 2024, 2024081669. https://doi.org/10.20944/preprints202408.1669.v1
Badia, J. M.; Amador, S.; González-Sánchez, C.; Rubio-Pérez, I.; Manuel-Vázquez, A.; Juvany, M.; Membrilla, E.; Balibrea, J. M.; Guirao, X. Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review. Preprints2024, 2024081669. https://doi.org/10.20944/preprints202408.1669.v1
APA Style
Badia, J. M., Amador, S., González-Sánchez, C., Rubio-Pérez, I., Manuel-Vázquez, A., Juvany, M., Membrilla, E., Balibrea, J. M., & Guirao, X. (2024). Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review. Preprints. https://doi.org/10.20944/preprints202408.1669.v1
Chicago/Turabian Style
Badia, J. M., José M Balibrea and Xavier Guirao. 2024 "Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review" Preprints. https://doi.org/10.20944/preprints202408.1669.v1
Abstract
Background. While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pan-creatitis (AP) is recommended, studies indicate a high rate of inadequate treatment.
Methods. A search of PubMed, Scopus, and Cochrane databases was conducted, focusing on primary research and meta-analyses. Data were categorized based on core concepts, and a narra-tive synthesis was performed.
Results. The searches yielded 1016 publications. After assessing 203 full texts and additional sources, 80 studies were included. The answers obtained were: (1) Preventive treatment does not decrease the incidence of IPN or mortality. Given the risks of bacteria resistance and fungal infec-tions, antibiotics should be reserved for highly suspected or confirmed IPN; (2) The diagnosis of IPN not always require microbiological samples, as clinical suspicion or CT signs can suffice. Early di-agnosis and treatment may be improved by using biomarkers such as procalcitonin and novel mi-crobiological methods; (3) When indicated, early initiation of antibiotics of IPN is a key determinant in reducing mortality; (4) Antibiotics with good penetration into pancreatic tissue covering Gram-negative and Gram-positive bacteria should be used. Routine antifungal therapy is not recommended; (5) The step-up approach, including antibiotics, is the standard for IPN manage-ment; (6) Antibiotic duration should be kept to a minimum and should be based on the quality of source control and patient condition.
Conclusions. Early antibiotic therapy is essential for the treatment of IPN, but prophylactic anti-biotics are not recommended in AP. High-quality RCTs are required to better understand the role of antibiotics and antifungals in AP management.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
