The Clinical Effect Of Prophylactic Antibiotic Therapy For Patients With Severe Acute Pancreatits A Meta-Analysis

Objective To determine whether prophylactic antibiotic within travenous is effiective in patients with severe acute pancreatitis.Methods Data sources Pubmed, Cochrane Library, Embase, and manual search. Study selection 313 articles were screened for randomized controlled studies (RCTs) that compared prophylactic antibiotic with placebo in patients with severe acute pancreatitis (SAP). Finally, seven RCTs were identified and included in the Meta-analysis. Data extraction seven RCTs with 465 participants were analyzed. The primary endpoint of this studies were to determine whether prophylaxis within travenous antibiotic treatment could reduce the incidence of infected pancreatic necrosis; Secondarily, we assessed effects on extrapancreatic infections, open antibiotic treantment, surgical treatment, mortality. The Meta-analysis was performed with the fixed effects model or random effects model.Results There were no significant differences between antibiotic group and control group in infected pancreatic necrosis [odds ratio (OR) 0.859,95% confidence interval (95%CI) 0.525-1.405, P= 0.545], extrapancreatic infections [OR 0.695,95%CI 0.377-1.282, P= 0.244], open antibiotic treantment [OR 0.673,95%CI 0.426-1.066, P=0.091], surgical treatment [OR 1.148,95%CI 0.715-1.843, P=0.568] and mortality [OR 0.885,95%CI 0.487-1.608, P= 0.688].Conclusion The Meta-analysis of all seven trials showes no benefit for prophylactic antibiotics in improving clinical outcomes for patients with severe acute pancreatitis.