Preventive strategies for septic complications of acute pancreatitis.

A. Oláh, G. Pardavi, T. Belágyi, L. Romics

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The diagram of the mortality of acute pancreatitis is characterized by two distinct peaks, in a similar manner to other generalized acute inflammatory responses. In the first phase, which is characterized by "hyper-inflammatory" mechanisms, death occurs due to overwhelming SIRS and subsequent multi-organ failure. The second peak of death is usually detected much later, at least two weeks after the onset of acute pancreatitis. Infection in necrotising pancreatitis is frequently observed in this so-called "compensatory antiinflammatory" phase. Since there has been no effective therapy evolved to prevent the activation of inflammatory and proteolytic cascades, the treatment of acute pancreatitis is merely symptomatic. Adequate fluid resuscitation and analgesia are the mainstays of treatment. In case of development of multi-organ failure, extensive medical and ventilatory supportive therapy is usually necessary. However, recent studies suggested certain methods might decrease the incidence of infection in pancreatic necrosis, which is usually due to bacterial translocation from the gut. Numerous attempts have been published in the literature to decrease the frequency of septic complications. Furthermore, the outcome of studies favouring antibiotic prophylaxis in acute pancreatitis were debatable. The development of multi-resistant strains of Gram-positive bacteria and Candida, due to long-term antibiotic use, is a strong argument against the indication of prophylactic antibiotic use. Recently, various clinical studies aimed to decrease bacterial translocation, including probiotic use and enteral feeding as part of the treatment. This paper provides a systematic review on data available in the evidence based literature on the use of antibiotics and the role of alternative and supportive therapy in the treatment of severe acute pancreatitis.

Original languageEnglish
Pages (from-to)383-388
Number of pages6
JournalChirurgia (Romania)
Volume102
Issue number4
Publication statusPublished - Jul 2007

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Pancreatitis
Bacterial Translocation
Anti-Bacterial Agents
Therapeutics
Antibiotic Prophylaxis
Probiotics
Gram-Positive Bacteria
Enteral Nutrition
Complementary Therapies
Infection
Candida
Resuscitation
Analgesia
Anti-Inflammatory Agents
Necrosis
Outcome Assessment (Health Care)
Mortality
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Oláh, A., Pardavi, G., Belágyi, T., & Romics, L. (2007). Preventive strategies for septic complications of acute pancreatitis. Chirurgia (Romania), 102(4), 383-388.

Preventive strategies for septic complications of acute pancreatitis. / Oláh, A.; Pardavi, G.; Belágyi, T.; Romics, L.

In: Chirurgia (Romania), Vol. 102, No. 4, 07.2007, p. 383-388.

Research output: Contribution to journalArticle

Oláh, A, Pardavi, G, Belágyi, T & Romics, L 2007, 'Preventive strategies for septic complications of acute pancreatitis.', Chirurgia (Romania), vol. 102, no. 4, pp. 383-388.
Oláh, A. ; Pardavi, G. ; Belágyi, T. ; Romics, L. / Preventive strategies for septic complications of acute pancreatitis. In: Chirurgia (Romania). 2007 ; Vol. 102, No. 4. pp. 383-388.
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