Prophylactic use of antibiotics in pancreatic sepsis: a 25-year reappraisal.

The efficacy of antibiotics given prophylactically in cases of acute pancreatitis is controversial. The authors carried out a retrospective review of 528 cases of pancreatitis seen between 1955 and 1980 and noted a marked increase in the number of septic complications and in the mortality related to sepsis. In most cases, infection was due to organisms sensitive to the antibiotics used, suggesting that they are not effective in preventing sepsis. The authors suggest a new approach to prophylactic administration of antibiotics, based on bioactive tissue levels in pancreatitis.