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Báo cáo y học: "A role for prophylactic antibiotics in necrotizing pancreatitis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: A role for prophylactic antibiotics in necrotizing pancreatitis? | Available online http ccforum.eom content 12 6 195 Commentary A role for prophylactic antibiotics in necrotizing pancreatitis Why we may never know the answer . Jan J De Waele Department of Critical Care Medicine Ghent University Hospital De Pintelaan 185 9000 Ghent Belgium Corresponding author Jan J De Waele jan.dewaele@ugent.be See related research by Fritz et al. http ccforum.com content 12 6 R141 Published 2 December 2008 This article is online at http ccforum.com content 12 6 195 2008 BioMed Central Ltd Critical Care 2008 12 195 doi 10.1186 cc7122 Abstract The use of prophylactic antibiotics in patients with severe acute pancreatitis remains an intensely debated topic. Although animal studies consistently demonstrated an advantage of antibiotic prophylaxis the only two blinded randomized controlled trials could not confirm these findings. Translation of the experimental models in human clinical practice is hampered by a number of fundamental differences between experimental pancreatitis and human disease and therefore it is highly unlikely that the pronounced benefit found in experimental pancreatitis will ever be demonstrated in human disease. Early and accurate risk stratification to identify the patient at risk for infection early in the course of the disease seems to be the greatest challenge. Until we are able to demonstrate an advantage of antibiotic prophylaxis in a high-risk human population the absence of proven benefit and potential side effects of this strategy should be acknowledged and the use of antibiotics should be limited to the treatment of documented infection. Early therapeutic or prophylactic administration of antibiotics In this issue of Critical Care Fritz and colleagues 1 describe how in a rat model of necrotizing pancreatitis prophylactic administration of antibiotics reduced mortality at 24 hours after induction of pancreatitis from 57 to 0 . Furthermore they compared early antibiotic treatment - antibiotics started 24 hours after .