BACKGROUND: Overall, the use of antibiotics in the treatment of patients with severe acute pancreatitis has increased owing to the use of antibiotic prophylaxis. HYPOTHESIS: The incidence of antibiotic-resistant (AB-R) bacteria in infected pancreatitis is related to prolonged antibiotic treatment and may affect outcome. DESIGN: Case series. SETTING: Fifty-six-bed intensive care unit of a tertiary care center. PATIENTS: Forty-six consecutive patients with infected pancreatic necrosis. MAIN OUTCOME MEASURES: Occurrence rate of AB-R organisms in pancreatic infection, overall duration of antibiotic treatment prior to infection, and mortality, defined as inhospital mortality. RESULTS: Infection with AB-R microorganisms was found in 24 (52%) of 46 patients. Primary infection was present in 7 patients; in 21 patients, nosocomial surinfection with AB-R organisms occurred. Patients with AB-R infections were treated with antibiotics for a longer period (24 vs 15 days, P<.05), while disease severity and the incidence of organ failure were not statistically significantly different. The intensive care unit stay was significantly longer in patients with AB-R infections (23 vs 31 days, P = .02). Mortality was not statistically significantly different in patients with AB-R infections (37% vs 28%, P = .23). CONCLUSIONS: The occurrence rate of infections with AB-R organisms in our patients with severe acute pancreatitis was high and was associated with a longer intensive care unit stay, but no increased mortality could be demonstrated. The duration of antibiotic treatment was increased in patients in whom AB-R infections developed.
BACKGROUND: Overall, the use of antibiotics in the treatment of patients with severe acute pancreatitis has increased owing to the use of antibiotic prophylaxis. HYPOTHESIS: The incidence of antibiotic-resistant (AB-R) bacteria in infected pancreatitis is related to prolonged antibiotic treatment and may affect outcome. DESIGN: Case series. SETTING: Fifty-six-bed intensive care unit of a tertiary care center. PATIENTS: Forty-six consecutive patients with infected pancreatic necrosis. MAIN OUTCOME MEASURES: Occurrence rate of AB-R organisms in pancreatic infection, overall duration of antibiotic treatment prior to infection, and mortality, defined as inhospital mortality. RESULTS: Infection with AB-R microorganisms was found in 24 (52%) of 46 patients. Primary infection was present in 7 patients; in 21 patients, nosocomial surinfection with AB-R organisms occurred. Patients with AB-R infections were treated with antibiotics for a longer period (24 vs 15 days, P<.05), while disease severity and the incidence of organ failure were not statistically significantly different. The intensive care unit stay was significantly longer in patients with AB-R infections (23 vs 31 days, P = .02). Mortality was not statistically significantly different in patients with AB-R infections (37% vs 28%, P = .23). CONCLUSIONS: The occurrence rate of infections with AB-R organisms in our patients with severe acute pancreatitis was high and was associated with a longer intensive care unit stay, but no increased mortality could be demonstrated. The duration of antibiotic treatment was increased in patients in whom AB-R infections developed.
Authors: Adrian C Vlada; Bradley Schmit; Andrew Perry; Jose G Trevino; Kevin E Behrns; Steven J Hughes Journal: HPB (Oxford) Date: 2013-10 Impact factor: 3.647
Authors: Nadav Sahar; Richard A Kozarek; Zaheer S Kanji; Shingo Chihara; S Ian Gan; Shayan Irani; Michael Larsen; Andrew S Ross; Michael Gluck Journal: Eur J Clin Microbiol Infect Dis Date: 2018-04-19 Impact factor: 3.267
Authors: Charlotte Garret; Emmanuel Canet; Stéphane Corvec; David Boutoille; Matthieu Péron; Isabelle Archambeaud; Aurélie Le Thuaut; Jean-Baptiste Lascarrou; Frédéric Douane; Marc Lerhun; Nicolas Regenet; Emmanuel Coron; Jean Reignier Journal: Ann Intensive Care Date: 2020-06-15 Impact factor: 6.925