Prophylactic antibiotics cannot reduce infected pancreatic necrosis and mortality in acute necrotizing pancreatitis: Evidence from a meta-analysis of randomized controlled trials
Prophylactic antibiotics cannot reduce infected pancreatic necrosis and mortality in acute necrotizing pancreatitis: Evidence from a meta-analysis of randomized controlled trials
复制标题
DOI：
10.1111/j.1572-0241.2007.01575.x
复制
发表时间：
2008-01-01
影响因子：
9.8
通讯作者：
Li, Zhao-shen
中科院分区：
文献类型：
--
作者：
Bai, Yu;Gao, Jun;Li, Zhao-shen
背景技术背景：静脉注射预防性抗生素是否能减少急性坏死性胰腺炎（ANP）的感染性胰腺坏死和死亡率尚无一致意见。方法：检索MEDLINE、EMBASE、科克伦对照试验数据库、科克伦图书馆、Science Citation Index等数据库，查找相关文献。结果：纳入7项试验，共467例患者。分析表明，感染性胰腺坏死率无显著差异（抗生素组17.8%，对照组22.9%），RR 0.81（95%CI 0.54-1.22）。抗生素组死亡率（9.3%）与对照组（15.2%）相比无显著性降低，RR 0.70（95%CI 0.42-1.17）。随后的亚组分析证实，在减少感染性坏死和死亡率方面，抗生素在统计学上并不优于对照组。结论：预防性抗生素不能减少ANP患者感染性胰腺坏死和死亡率。上级。
BACKGROUND: There is no agreement whether intravenous prophylactic antibiotics can reduce infected pancreatic necrosis and mortality in acute necrotizing pancreatitis (ANP). We performed a meta-analysis comparing intravenous antibiotics with placebo or no treatment in randomized controlled trials (RCTs).METHODS: Databases including MEDLINE, EMBASE, the Cochrane controlled trials register, the Cochrane Library, and Science Citation Index were searched to find relevant trials. Outcome measures were infected necrosis and mortality.RESULTS: Seven trials involving 467 patients were included. Analysis suggested infected pancreatic necrosis rates were not significantly different (antibiotics 17.8%, controls 22.9%), RR 0.81 (95% CI 0.54-1.22). There was nonsignificantly decreased mortality with antibiotics (9.3%) versus controls (15.2%), RR 0.70 (95% CI 0.42-1.17). Subsequent subgroup analysis confirmed antibiotics were not statistically superior to controls in reduction of infected necrosis and mortality.CONCLUSIONS: Prophylactic antibiotics cannot reduce infected pancreatic necrosis and mortality in patients with ANP.