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Prevention of bacterial infection and sepsis in acute severe pancreatitis.

Authors
  • McClelland, P
  • Murray, A
  • Yaqoob, M
  • Van Saene, H K
  • Bone, J M
  • Mostafa, S M
Type
Published Article
Journal
Annals of the Royal College of Surgeons of England
Publication Date
Sep 01, 1992
Volume
74
Issue
5
Pages
329–334
Identifiers
PMID: 1329602
Source
Medline
License
Unknown

Abstract

Between 1984 and 1986 six patients with acute respiratory failure (requiring ventilation for at least 3 days) complicating acute pancreatitis were managed on the intensive care unit (median ventilation period 6 days; range 3-41 days). Between 1987 and 1989 nine similar patients were managed (median ventilation period 35 days, range 4-69 days), and a regimen of enteral tobramycin, polymyxin and amphotericin to selectively decontaminate the digestive tract (SDD) was introduced. Five of six patients treated before 1987 had serious infections (three Gram-negative, one fungal), compared with only one of nine patients treated with SDD (P < 0.05). Clinical signs of sepsis were evident for 62% of the pre-SDD period, compared with 39% of the period during SDD therapy (P < 0.001). Systemic antibiotic prescribing was reduced in the SDD group; however, mortality remained unaffected with only two patients surviving pre-SDD and three during SDD treatment. SDD reduces infection rates and sepsis in patients with acute pancreatitis and may help to improve the prognosis of this life-threatening condition.

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