medigraphic.com
Colegio de Medicos y Cirujanos República de Costa Rica

2013, Number 608

<< Back Next >>

Rev Med Cos Cen 2013; 70 (608)

El papel de la terapia antimicrobiana en la pancreatitis aguda severa

Rodríguez MM

Language: Spanish
References: 12
Page: 631-638
PDF size: 180.31 Kb.


ABSTRACT

The role of antimicrobial therapy in patients with severe acute pancreatitis is to treat secondary pancreatic infections to prevent systemic sepsis and death. Infected pancreatic necrosis is diagnosed using image-directed fine needle aspiration with culture and Gram’s stain. Prophylactic antibiotics have not proven efficacious, while the precise timely detection of secondary pancreatic infections is often elusive. A high clinical index of suspicion should prompt the empiric initiation of antimicrobial therapy until culture results are available. Positive cultures should guide antimicrobial therapy, and for infected pancreatic necrosis, antibiotics should be used in conjunction with interventional techniques for source control.


REFERENCES

  1. Anand N. (March, 2012). Modern management of acute pancreatitis. Gastroenteroly Clinics, Vol 41(1); 1-8.

  2. Baron T.H., Morgan D.E.(1999). Acute necrotizing pancreatitis. N Engl J Med, Vol 340. (18); 1412- 1417.

  3. Cappell MS. (Jul, 2008). Acute pancreatitis: etiology, clinical presentation, diagnosis, and therapy. Med Clin North Am, Vol 92(4); 889- 923.

  4. Crocker JT. (April, 2012). Acute Pancreatitis. Hospital Medicine Clinics, Vol 1 (2); 209-222.

  5. Dellinger E.P., Tellado J.M., Soto N.E., et al. (2007). Early antibiotic treatment for severe acute necrotizing pancreatitis: randomized, doubleblind, placebo-controlled study. Ann Surg, Vol 245; 674-683.

  6. Giovannini M. (April, 2012;). Endoscopic ultrasonography-guided pancreatic drainage. Gastrointest Endosc Clin N Am, Vol 22(2); 221- 30.

  7. Guzman E.A., Rudnicki M. (2006). Intricacies of host response in acute pancreatitis. J Am Coll Surg, Vol 202. (3); 509-519.

  8. Howard TJ. (June, 2013). The Role of Antimicrobial Therapy in Severe Acute Pancreatitis. Surg Clin North Am, Vol 93(3); 585-593.

  9. Isenmann R., Rünzi M., Kron M., et al. (2004). Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebocontrolled, double blind trial. Gastroenterology, Vol 126; 997- 1004.

  10. Klar E., Endrich B., Messmer K.(1990) Microcirculation of the pancreas. A quantitative study of physiology and changes in pancreatitis. Int J Microcirc Clin. Vol 9; 85-101.

  11. Sarr MG. (June, 2013). The New Revised Classification of Acute Pancreatitis 2012. Surgical Clinics, Vol 93(3); 549-562.

  12. Schneider L. (Dec, 2010). Acute pancreatitis with an emphasis on infection. Infect Dis Clin North Am, Vol 24(4); 921-941.




2020     |     www.medigraphic.com