Over- and Misuse of Antibiotics and the Clinical Consequence in Necrotizing Pancreatitis: An Observational Multicenter Study.
Hester C TimmerhuisFons F van den BergPaula C NoordaSven M van DijkJanneke van GrinsvenChristina J Sperna WeilandDevica S UmansYasmin A MohamedWouter L CurversStefan A W BouwenseMuhammed HadithiAkin IndersonYama IssaJeroen M JansenPieter Jan F de JongeRutger QuispelMatthijs P SchwartzMartijn Willem Jan StommelAdriaan C I T L TanNiels G VennemanMarc G H BesselinkMarco J BrunoThomas L BollenElske SieswerdaRobert C VerdonkRogier P VoermansHjalmar C van Santvoortnull nullPublished in: Annals of surgery (2023)
In this nationwide study of patients with necrotizing pancreatitis, the vast majority received antibiotics, typically administered early in the disease course and without a proven infection. Empirical antibiotics were inappropriate based on pancreatic cultures in half the patients. Future clinical research and practice must consider antibiotic selective pressure due to prolonged therapy, coverage of Enterococcus and yeast. Improved guidelines on antimicrobial diagnostics and therapy could reduce inappropriate antibiotic use and improve clinical outcomes.