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Therapeutic antibiotics for acute pancreatitis has been a controversial issue; most data indicate no benefit over supportive care. Antibiotic prophylaxis has, however, yielded some benefit in severe necrotizing or hemorrhagic pancreatitis. These authors conducted a prospective, multisite, controlled study comparing imipenem, a drug that has proven useful in this setting, with pefloxacin, which has a favorable antimicrobial spectrum and pancreatic penetration for treatment of these conditions.
Sixty patients with necrotizing pancreatitis involving more than 50% of the gland, as measured by contrast computerized tomography, were randomized to receive either imipenem or pefloxacin; the groups were well matched. Patients were followed with ultra…