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Imipenem prophylaxis for predicted severe acute pancreatitis - Preliminary results of a randomized clinical trial


Poropat, Goran; Giljača, Vanja; Licul, Vanja; Hauser, Goran; Milić, Sandra; Štimac, Davor
Imipenem prophylaxis for predicted severe acute pancreatitis - Preliminary results of a randomized clinical trial // Pancreatology
Liverpool, Velika Britanija, 2016. str. 523-528 (poster, međunarodna recenzija, sažetak, znanstveni)


Naslov
Imipenem prophylaxis for predicted severe acute pancreatitis - Preliminary results of a randomized clinical trial

Autori
Poropat, Goran ; Giljača, Vanja ; Licul, Vanja ; Hauser, Goran ; Milić, Sandra ; Štimac, Davor

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Pancreatology / - , 2016, 523-528

Skup
48th European Pancreatic Club

Mjesto i datum
Liverpool, Velika Britanija, 6-9.7.2016

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Acute pancreatitis, imipenem, prophylaxis, randomized controlled trial

Sažetak
Introduction: Infected necrosis is a serious complication of acute pancreatitis leading to a mortality rate of about 40%. Although prophylactic antibiotics are not recommended, meta-analytic data show that imipenem significantly reduces the rate of infected necrosis. Aims: To evaluate the prophylactic use of imipenem in patients with predicted severe acute pancreatitis. Patients & methods: We conducted a single- center, prospective randomized trial. Patients with AP and an APACHE II  8 were randomized to receive either imipenem 500 mg i.v. three times daily for the first ten days or an identical placebo. Exclusion criteria included age < 18 years, any infection present at admission, chronic pancreatitis, active malignancy, immunodeficiency, post-surgical patients, pregnant and breastfeeding women and patients unwilling to participate. Concomitant treatment was similar in both groups. All patients had an abdominal CT scan performed between days 3 to 7, and in cases of clinically suspected infected pancreatic necrosis. Results: Forty- seven consecutive patients were randomized. Twentythree received imipenem and 24 received placebo. Three patients died in the imipenem group, while two patients died in the placebo group (p=0, 667). There were no differences in the occurrence of infected necrosis, with 2 vs. 3 cases, respectively. Other local complications were present in 7 and 13 patients (p¼0, 142), while persistent organ failure was present in 4 and 5 patients (p¼1, 00) in imipenem and placebo group, respectively. Other infection were detected in 2 patients receiving imipenem and 5 patients on placebo (p¼0, 416). Conclusion: Preliminary data showed no significant beneficial effects of prophylactic imipenem in patients with predicted severe acute pancreatitis.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti



POVEZANOST RADA


Ustanove
Medicinski fakultet, Rijeka,
Klinički bolnički centar Rijeka

Časopis indeksira:


  • Current Contents Connect (CCC)
  • Web of Science Core Collection (WoSCC)
    • Science Citation Index Expanded (SCI-EXP)
  • Scopus
  • MEDLINE