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Surg Clin North Am. 2013 Jun;93(3):585-93. doi: 10.1016/j.suc.2013.02.006. Epub 2013 Apr 13.

The role of antimicrobial therapy in severe acute pancreatitis.

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Hepatobiliary Surgical Cancer Care, Community Hospital North, 8040 Clearvista Parkway, Suite 240, Indianapolis, IN 46256, USA.


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.

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