Appropriate use of antibiotics in acute pancreatitis: a scoping review

Background: While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pancreatitis (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-anal...

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Autores: Badia, Josep M, Amador, Sara, Gonzalez-Sanchez, Carmen, Rubio-Pérez, Inés, Manuel-Vazquez, Alba, Juvany, Montserrat, Membrilla, Estela, Balibrea, José M., GUIRAO, XAVIER
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:20.500.12328/4412
Acceso en línea:http://hdl.handle.net/20.500.12328/4412
https://dx.doi.org/10.3390/antibiotics13090894
Access Level:acceso abierto
Palabra clave:Pancreatitis aguda
Necrosi pancreàtica infectada
Antibiòtics
Microbiologia
Teràpia profilàctica
Durada del tractament
Acute pancreatitis
Infected pancreatic necrosis
Antibiotics
Microbiology
Prophylactic therapy
Duration of treatment
00
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spelling Appropriate use of antibiotics in acute pancreatitis: a scoping reviewBadia, Josep MAmador, SaraGonzalez-Sanchez, CarmenRubio-Pérez, InésManuel-Vazquez, AlbaJuvany, MontserratMembrilla, EstelaBalibrea, José M.GUIRAO, XAVIERPancreatitis agudaNecrosi pancreàtica infectadaAntibiòticsMicrobiologiaTeràpia profilàcticaDurada del tractamentPancreatitis agudaNecrosi pancreàtica infectadaAntibiòticsMicrobiologiaDurada del tractamentTeràpia profilàcticaAcute pancreatitisInfected pancreatic necrosisAntibioticsMicrobiologyProphylactic therapyDuration of treatment00Background: While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pancreatitis (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 narrative synthesis was performed. Results: The search identified a total of 1016 publications. After evaluating 203 full texts and additional sources from the grey literature, 80 studies were included in the review. The answers obtained were: (1) Preventive treatment does not decrease the incidence of IPN or mortality. Given the risks of bacterial resistance and fungal infections, antibiotics should be reserved for highly suspected or confirmed IPN; (2) The diagnosis of IPN does not always require microbiological samples, as clinical suspicion or computed tomography signs can suffice. Early diagnosis and treatment may be improved by using biomarkers such as procalcitonin and novel microbiological methods; (3) When indicated, early initiation of antibiotics is a key determinant in reducing mortality associated with IPN; (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 management; (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 antibiotics are not recommended in AP. High-quality randomized controlled trials are required to better understand the role of antibiotics and antifungals in AP management.info:eu-repo/semantics/publishedVersionMDPI2024info:eu-repo/semantics/article14http://hdl.handle.net/20.500.12328/4412https://dx.doi.org/10.3390/antibiotics13090894reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésAntibiotics13;9© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:20.500.12328/44122026-05-29T05:05:01Z
dc.title.none.fl_str_mv Appropriate use of antibiotics in acute pancreatitis: a scoping review
title Appropriate use of antibiotics in acute pancreatitis: a scoping review
spellingShingle Appropriate use of antibiotics in acute pancreatitis: a scoping review
Badia, Josep M
Pancreatitis aguda
Necrosi pancreàtica infectada
Antibiòtics
Microbiologia
Teràpia profilàctica
Durada del tractament
Pancreatitis aguda
Necrosi pancreàtica infectada
Antibiòtics
Microbiologia
Durada del tractament
Teràpia profilàctica
Acute pancreatitis
Infected pancreatic necrosis
Antibiotics
Microbiology
Prophylactic therapy
Duration of treatment
00
title_short Appropriate use of antibiotics in acute pancreatitis: a scoping review
title_full Appropriate use of antibiotics in acute pancreatitis: a scoping review
title_fullStr Appropriate use of antibiotics in acute pancreatitis: a scoping review
title_full_unstemmed Appropriate use of antibiotics in acute pancreatitis: a scoping review
title_sort Appropriate use of antibiotics in acute pancreatitis: a scoping review
dc.creator.none.fl_str_mv Badia, Josep M
Amador, Sara
Gonzalez-Sanchez, Carmen
Rubio-Pérez, Inés
Manuel-Vazquez, Alba
Juvany, Montserrat
Membrilla, Estela
Balibrea, José M.
GUIRAO, XAVIER
author Badia, Josep M
author_facet Badia, Josep M
Amador, Sara
Gonzalez-Sanchez, Carmen
Rubio-Pérez, Inés
Manuel-Vazquez, Alba
Juvany, Montserrat
Membrilla, Estela
Balibrea, José M.
GUIRAO, XAVIER
author_role author
author2 Amador, Sara
Gonzalez-Sanchez, Carmen
Rubio-Pérez, Inés
Manuel-Vazquez, Alba
Juvany, Montserrat
Membrilla, Estela
Balibrea, José M.
GUIRAO, XAVIER
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Pancreatitis aguda
Necrosi pancreàtica infectada
Antibiòtics
Microbiologia
Teràpia profilàctica
Durada del tractament
Pancreatitis aguda
Necrosi pancreàtica infectada
Antibiòtics
Microbiologia
Durada del tractament
Teràpia profilàctica
Acute pancreatitis
Infected pancreatic necrosis
Antibiotics
Microbiology
Prophylactic therapy
Duration of treatment
00
topic Pancreatitis aguda
Necrosi pancreàtica infectada
Antibiòtics
Microbiologia
Teràpia profilàctica
Durada del tractament
Pancreatitis aguda
Necrosi pancreàtica infectada
Antibiòtics
Microbiologia
Durada del tractament
Teràpia profilàctica
Acute pancreatitis
Infected pancreatic necrosis
Antibiotics
Microbiology
Prophylactic therapy
Duration of treatment
00
description Background: While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pancreatitis (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 narrative synthesis was performed. Results: The search identified a total of 1016 publications. After evaluating 203 full texts and additional sources from the grey literature, 80 studies were included in the review. The answers obtained were: (1) Preventive treatment does not decrease the incidence of IPN or mortality. Given the risks of bacterial resistance and fungal infections, antibiotics should be reserved for highly suspected or confirmed IPN; (2) The diagnosis of IPN does not always require microbiological samples, as clinical suspicion or computed tomography signs can suffice. Early diagnosis and treatment may be improved by using biomarkers such as procalcitonin and novel microbiological methods; (3) When indicated, early initiation of antibiotics is a key determinant in reducing mortality associated with IPN; (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 management; (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 antibiotics are not recommended in AP. High-quality randomized controlled trials are required to better understand the role of antibiotics and antifungals in AP management.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12328/4412
https://dx.doi.org/10.3390/antibiotics13090894
url http://hdl.handle.net/20.500.12328/4412
https://dx.doi.org/10.3390/antibiotics13090894
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Antibiotics
13;9
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 14
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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