ANTIBIOTIC-TREATMENT IMPROVES SURVIVAL IN EXPERIMENTAL ACUTE NECROTIZING PANCREATITIS

Background & Aims: It is still unproven whether prophylactic antibioti cs can reduce mortality from acute necrotizing pancreatitis (ANP). The aim of this study was to investigate whether antibiotic therapy can i nfluence long-term outcome in ANP and how appropriate this therapy is, Methods: ANP was induced in rats by standardized intraductal bile aci d infusion and cerulein hyperstimulation. Serum trypsinogen activation peptide levels were used to verify comparable disease severity, Start ing 6 hours after induction, animals randomly received saline (n = 60) , 20 mg/kg imipenem (n = 62), or 10 mg/kg ciprofloxacin (n = 60) every 8 hours for 7 days. On day 7, half of each group was killed so a quan titative pancreatic bacteriology could be conducted. The other half wa s analyzed at 21 days for long-term mortality, late bacteriologic chan ges, abscesses, and pseudocysts. Results: Comparable trypsinogen activ ation peptide increases confirmed equally severe ANP in each group bef ore treatment, Imipenem and ciprofloxacin significantly reduced the nu mber of infected pancreatic specimens, bacterial counts, and identifie d species at 1 week. At 3 weeks, pancreatic infection prevalence was l ower in animals treated with antibiotics; abscess formation was reduce d and pseudocysts were smaller and less frequently infected, Survival was significantly improved by imipenem and ciprofloxacin. Conclusions: Antibiotic treatment reduces early and late septic pancreatic complic ations and improves survival from experimental ANP.