A RANDOMIZED MULTICENTER CLINICAL-TRIAL OF ANTIBIOTIC-PROPHYLAXIS OF SEPTIC COMPLICATIONS IN ACUTE NECROTIZING PANCREATITIS WITH IMIPENEM

Recent evidence of pancreatic penetration of several antibiotics activ e against the usual flora found in pancreatic sepsis, at therapeutic m inimal inhibitory concentration, prompted the authors to perform a ran domized, multicenter, clinical trial on imipenem prophylaxis in acute pancreatitis. Seventy-four patients with computed tomographic (CT) sca ns demonstrating necrotizing pancreatitis within 72 hours of onset wer e randomly assigned to two groups receiving no antibiotic treatment or 0.5 gram of prophylactic imipenem administered intravenously every ei ght hours for two weeks. Pancreatic sepsis was always detected by mean s of cultures (percutaneous CT or ultrasound-guided needle aspiration and intraoperative samples). The incidence of pancreatic sepsis was mu ch less in treated patients (12.2 versus 30.3 percent, p<0.01). Theref ore, the authors recommend prophylactic use of imipenem in patients wi th acute necrotizing pancreatitis.