Antibiotics in acute biliary pancreatitis

ABSTRACT

The value of antibiotic therapy in acute biliary pancreatitis was assessed in a prospective study including 40 patients with 43 attacks over a three-year period at Ain Shams University Hospital, Cairo, Egypt and Namas General Hospital, Assir, K.S.A. The criteria for inclusion in this study were a consistent clinical picture, hyperamylasemia and an ultrasound evidence of biliary stones or sludge. On the basis of laboratory findings, 77.5% of cases were graded as "mild" pancreatitis, whereas 22.5% were graded as "severe" pancreatitis. Twenty patients [20 attacks] were managed conservatively with intravenous fluids, nasogastric aspiration and analgesics, while in the remaining 20 patients [23 attacks], antibiotics were added. Patients managed without antibiotics developed mortality and complication rates of 10% for each. However, no deaths nor significant complications were recorded in the group treated with antibiotics. The time interval to resume normal laboratory criteria and start oral intake and hospitalization were significantly shorter in the group treated with antibiotics. In conclusion, antibiotic therapy is of great invaluability in the management of acute biliary pancreatitis and should be used routinely to achieve good prognosis