THERAPEUTIC EFFECTS OF CONTINUOUS INTRAARTERIAL ANTIBIOTIC INFUSION IN PREVENTING PANCREATIC INFECTION IN EXPERIMENTAL ACUTE NECROTIZING PANCREATITIS

To determine the efficacy of antibiotics in the prevention of pancreat ic infection and the process of aggravation after induction of acute p ancreatitis, antibiotic was administrated intravenously or intraarteri ally, starting 6 h after acute pancreatitis was induced in dogs by inj ecting autologous gallbladder bile into the main pancreatic duct. Flom oxef, recognized as an antibiotic able to penetrate well into pancreas tissue, was selected for the present study. Animals were divided into three groups: no antibiotic given (Group A), antibiotic given intrave nously as a bolus injection of 25 mg/kg every 6 h (Group B), and antib iotic infused continuously into the celiac trunk (4 mg/kg/h) (Group C) . Compared with Group A, continuous intraarterial infusion of antibiot ic (Group C) significantly improved the survival rate and decreased th e serum levels of phospholipase A(2)(PLA(2)) activity and endotoxin. F urthermore, it completely prevented the occurrence of pancreatic infec tion, not only ameliorating the severity of pancreatic necrosis but al so reducing the activity levels of amidase, trypsin-like enzyme, and P LA(2) in pancreas tissue. Group B showed little beneficial effect. Ant ibiotic concentration in peripheral blood and pancreas tissue was sign ificantly higher in Group C than in Group B. These results suggest tha t continuous arterial infusion of antibiotics into the feeding artery of the pancreas is an effective modality for preventing pancreatic inf ection aggravation of severe acute pancreatitis.