Powell J J, Miles R, Siriwardena A K
University Department of Surgery, Royal Infirmary of Edinburgh, UK.
Br J Surg. 1998 May;85(5):582-7. doi: 10.1046/j.1365-2168.1998.00767.x.
The role of antibiotic prophylaxis in the initial management of patients with acute pancreatitis is an area of major controversy. Contrary to earlier clinical trials, recent experimental and clinical studies have accrued evidence that warrants reappraisal of current clinical practice. This article reviews these recent advances in knowledge.
All papers derived from a Medline search for the years 1990-1997 inclusive using the text words 'acute', 'pancreatitis', 'antibiotic' and 'antibiotics' were studied. Additional papers were derived from reference lists within papers identified by the Medline search. Only experimental and clinical papers relevant to the issue of prophylactic antibiotic therapy in acute pancreatitis are included in the review.
Current experimental evidence favours the use of prophylactic antibiotics in severe acute pancreatitis. The results of contemporary randomized clinical trials restricted to patients with prognostically severe acute pancreatitis have demonstrated improvement in outcome associated with antibiotic treatment.
抗生素预防性治疗在急性胰腺炎患者初始治疗中的作用是一个存在重大争议的领域。与早期临床试验相反，近期的实验和临床研究积累了一些证据，这些证据使得有必要对当前的临床实践进行重新评估。本文综述了这些最新的知识进展。
研究了通过Medline检索1990年至1997年（含）期间使用关键词“急性”“胰腺炎”“抗生素”和“抗菌素”获得的所有论文。其他论文则来自Medline检索所确定论文的参考文献列表。本综述仅纳入与急性胰腺炎预防性抗生素治疗问题相关的实验和临床论文。
目前的实验证据支持在重症急性胰腺炎中使用预防性抗生素。仅限于预后严重的急性胰腺炎患者的当代随机临床试验结果表明，抗生素治疗可改善预后。
