Anbx in pancreatitis

 Q: Antibiotics are indicated along with antifungals in severe acute pancreatitis.

A) True

B) False

Answer: B

Infections occur only in one-fifth of patients with acute pancreatitis. In general, prophylactic antibiotics are not recommended, and this is irrespective of severity. Also, the development/demonstration of interstitial or necrotizing pancreatitis should not prompt automatic initiation of antibiotics. 

Said that, a clinician should start broad-spectrum antibiotics if an infection is suspected.  Simultaneously, appropriate de-escalation is advised. 

Prophylactic antifungal is not recommended to be added along with antibiotics unless there is a high suspicion of fungal infection.

#GI

References:

1. Soulountsi V, Schizodimos T. Use of antibiotics in acute pancreatitis: ten major concerns. Scand J Gastroenterol. 2020 Oct;55(10):1211-1218. doi: 10.1080/00365521.2020.1804995. Epub 2020 Aug 17. PMID: 32805137. 

2. Beger HG, Gansauge F, Poch B, Schwarz M. The use of antibiotics for acute pancreatitis: is there a role? Curr Infect Dis Rep. 2009 Mar;11(2):101-7. doi: 10.1007/s11908-009-0015-5. PMID: 19239799. 

3. Golub R, Siddiqi F, Pohl D. Role of antibiotics in acute pancreatitis: A meta-analysis. J Gastrointest Surg. 1998 Nov-Dec;2(6):496-503. doi: 10.1016/s1091-255x(98)80048-6. PMID: 10457308. 

4. Trikudanathan G, Navaneethan U, Vege SS. Intra-abdominal fungal infections complicating acute pancreatitis: a review. Am J Gastroenterol 2011; 106:1188.