Prophylactic Antibiotics in Severe Pancreatitis?

Several small studies have suggested that prophylactic antibiotics benefit patients with severe acute pancreatitis. However, one recent study — the largest, and the first to be placebo-controlled — failed to demonstrate better outcomes with prophylactic antibiotics. Now we have a second placebo-controlled trial.

Researchers enrolled 100 patients who had either more than 30% pancreatic necrosis on contrast computed tomography scan or — for patients unable to receive contrast — specified clinical findings consistent with substantial necrosis. Within 5 days of symptom onset, patients were randomized to receive at least 7 days of meropenem or placebo. During 6 weeks of follow-up, no significant differences were observed between groups in infecti…