Acute Pancreatitis: Management of Complicating Infection
| Autor: | Henry L. Laws, Raleigh B. Kent |
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| Rok vydání: | 2000 |
| Předmět: | |
| Zdroj: | The American Surgeon. 66:145-152 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313480006600209 |
| Popis: | Acute pancreatitis develops precipitously, changing the patient's condition from apparent good health to a critically ill status. Of patients who succumb, 80 per cent die from secondary infection in the pancreas-peripancreatic area. Infection supervenes in the second week or later after onset. Prophylactic antibiotic(s) appear to be helpful in avoiding, delaying, and/or lessening secondary sepsis. Once infection develops, treatment requires open debridement of necrotic material, drainage, and appropriate antibiotic therapy; or mortality will approach 100 per cent. Infecting organisms are commonly Escherichia coli, Klebsiella, Staphylococcus, Enterococcus, Bacteroides, and/or fungi. Antibiotics felt to be preferable for prophylactic therapy include 1) imipenem-cilastatin, 2) a quinolone + metronidazole, and 3) possibly an extended-spectrum penicillin. Treatment should be continued for 2 weeks or until recovery. Because fungus infections are occurring more often, prophylaxis with fluconazole may be warranted. |
| Databáze: | OpenAIRE |
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