Procon debate Antifungal prophylaxis is important to prevent fungal infection in patients with acute necrotizing pancreatitis receiving broad-spectrum antibiotics 英文参考文献.docVIP

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Procon debate Antifungal prophylaxis is important to prevent fungal infection in patients with acute necrotizing pancreatitis receiving broad-spectrum antibiotics 英文参考文献.doc

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Procon debate Antifungal prophylaxis is important to prevent fungal infection in patients with acute necrotizing pancreatitis receiving broad-spectrum antibiotics 英文参考文献

Available online /content/10/5/229 Review Pro/con debate: Antifungal prophylaxis is important to prevent fungal infection in patients with acute necrotizing pancreatitis receiving broad-spectrum antibiotics Philippe Eggimann1, Saurabh Jamdar2 and Ajith K Siriwardena2 1Department of Intensive Care Medicine and Burn Unit, Interdisciplinary Department for Support and Technics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland 2Hepatobiliary Surgery Unit, Department of Surgery, Manchester Royal Infirmary, Manchester, UK Corresponding author: A Siriwardena, Ajith.Siriwardena@CMMC.nhs.uk Published: 7 September 2006 Critical Care 2006, 10:229 (doi:10.1186/cc5025) This article is online at /content/10/5/229 ? 2006 BioMed Central Ltd Abstract The scenario A 47 year old male presents to your intensive care unit with evidence of severe pancreatitis. He develops multi-organ When critically ill patients with pancreatitis develop infection of the pancreas, the ongoing management of such patients becomes difficult. Sufficient evidence supports the use of broad-spectrum antibiotic prophylaxis to prevent the development of bacterial infection. Since fungal infection is also a relatively common complication of severe pancreatitis – particularly when broad- spectrum antibiotics are used – it seems logical that fungal prophylaxis may be an important component of management. In this issue of Critical Care, two expert groups debate the merits of necrotizing failure, including the need for intubation/mechanical ventilation, inotropes and dialysis. Although the cause of his pancreatitis is not clear, there is evidence of pancreatic necrosis on abdominal imaging. As a result you start broad- spectrum antibiotics and plan on-going management with the surgical team. Given that you understand these patients are at high risk for fungal infection, you wonder ab