Prophylactic antibiotic treatment is superior to therapy on-demand in experimental necrotising pancreatitis 英文参考文献.docVIP

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Prophylactic antibiotic treatment is superior to therapy on-demand in experimental necrotising pancreatitis 英文参考文献.doc

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Prophylactic antibiotic treatment is superior to therapy on-demand in experimental necrotising pancreatitis 英文参考文献

Available online /content/12/6/R141 Research Open Access Vol 12 No 6 Prophylactic antibiotic treatment is superior to therapy on-demand in experimental necrotising pancreatitis Stefan Fritz1, Werner Hartwig1, Ronny Lehmann1, Katja Will-Schweiger2, Mechthild Kommerell2, Thilo Hackert1, Lutz Schneider1, Markus W Büchler1 and Jens Werner1 1Department of General and Visceral Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany 2Section Infectiology, Institute of Hygiene, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany Corresponding author: Jens Werner, jens.werner@med.uni-heidelberg.de Received: 13 May 2008 Revisions requested: 26 Jun 2008 Revisions received: 9 Oct 2008 Accepted: 16 Nov 2008 Published: 16 Nov 2008 Critical Care 2008, 12:R141 (doi:10.1186/cc7118) This article is online at: /content/12/6/R141 ? 2008 Fritz et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction High morbidity and mortality rates in patients with severe acute pancreatitis are mainly caused by bacterial superinfection of pancreatic necrosis and subsequent sepsis. remains controversial because clinical studies performed to date were statistically underpowered. Thus, the aim of this study was to evaluate on-demand versus prophylactic antibiotic treatment in a standardised experimental model. pancreatitis. The 72-hour-mortality rate was 42.9% and bacterial infection of mesenteric lymph nodes and bacteraemia was found in 87.5% of the surviving animals. Therapeutic administration of meropenem on-demand reduced bacteraemia to 50% and mortality to 27.3%. However, prophylactic antibiotic treatment significantly reduced bacteraemia to 2