Discuss the role of systemic antibiotic therapy in patients with severe acute pancreatitis
Background / Rationale:
Systemic antibiotics in severe acute pancreatitis (SAP) have a potential role in three areas:
Evidence and Practice Guidelines:
The correct answer to this question is "role? there is none". However, it is a ten-mark SAQ. So, here is an example of how to say "none" using approximately extra 400 words.
Potential uses of antibiotics in pancreatitis
Coincidental treatment of extrapancreatic infection
Treatment of infected pancreatic necrosis
Arguments for the use of prophylactic antibiotics in severe pancreatitis
Counterarguments to the routine use of prophylactic of antibiotics
Antibiotic choice (if you felt compelled to give them)
Guidelines and "own practice"
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Tenner, Scott, et al. "American College of Gastroenterology guideline: management of acute pancreatitis." The American journal of gastroenterology 108.9 (2013): 1400-1415.
Jiang, Kun, et al. "Present and future of prophylactic antibiotics for severe acute pancreatitis." World J Gastroenterol 18.3 (2012): 279-84.
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Larvin, Mike. "Management of infected pancreatic necrosis." Current gastroenterology reports 10.2 (2008): 107-114.
Banks, Peter A. "Pro: computerized tomographic fine needle aspiration (CT-FNA) is valuable in the management of infected pancreatic necrosis." The American journal of gastroenterology 100.11 (2005): 2371.
Pappas, Theodore N. "Con: computerized tomographic aspiration of infected pancreatic necrosis: the opinion against its routine use." The American journal of gastroenterology 100.11 (2005): 2373.
Villatoro, Eduardo, Mubashir Mulla, and Mike Larvin. "Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis." The Cochrane Library (2010).