Survey of antibiotic prophylaxis in acute pancreatitis in the UK and Ireland

Background: Current surgical practice with regards to antibiotic prophylaxi s in acute pancreatitis in the UK and Ireland was overviewed. Methods: The 1103 members of the Association of Surgeons of Great Britain a nd Ireland were surveyed by postal questionnaire. A total of 528 replies we re received (48 per cent). Following exclusion of surgeons not treating pat ients with acute pancreatitis, analysis was carried out on 429 replies. Results: Respondents treated a median of 12 (interquartile range (i.q.r.) 1 0-20) patients per year with acute pancreatitis. Prophylactic antibiotic th erapy was used by 88 per cent of responding surgeons, of whom 24 per cent u sed it in all cases. For surgeons professing selective use of antibiotics, the most common indication for use was in patients with prognostically seve re disease. A cephalosporin was prescribed in 72 per cent of patients; cefu roxime was the single most common antibiotic, Combination therapy with metr onidazole was used in 48 per cent of attacks. The median duration of antibi otic therapy was 5 (i.q.r. 5-7) days. An adverse drug reaction attributable to the use of prophylactic antibiotics was reported by 11 per cent of resp ondents. Conclusion: This study has established that a significant body of clinician s charged with the responsibility of treating acute pancreatitis use antibi otic prophylaxis in the initial treatment of patients with predicted severe disease.