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Effect of early and late antibiotic treatment in experimental acute pancreatitis in rats

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Abstract

Background

The clinical course in acute necrotizing pancreatitis is mainly determined by bacterial infection of pancreatic and peripancreatic necrosis. The effect of two antibiotic regimens for early and late treatment was investigated in the taurocholate model of necrotizing pancreatitis in the rat.

Materials and methods

Seventy male Wistar rats were divided into five pancreatitis groups (12 animals each) and a sham-operated group (10 animals). Pancreatitis was induced by intraductal infusion of 3% taurocholate under sterile conditions. Animals received two different antibiotic regimes (20 mg/kg imipenem or 20 mg/kg ciprofloxacin plus 20 mg/kg metronidazole) early at 2, 12, 20, and 28 h after induction of pancreatitis or late at 16 and 24 h after induction of pancreatitis or no antibiotics (control). Animals were examined after 30 h for pancreatic and extrapancreatic infection.

Results

Early and late antibiotic treatment with both regimes could significantly reduce pancreatic infection from 58 to 8–25%. However, extrapancreatic infection was only reduced by early antibiotic therapy. While quinolones also reduced bacterial counts in small and large bowel, imipenem did not.

Conclusions

In our animal model of necrotizing pancreatitis, early and late treatment with ciprofloxacin/metronidazole and imipenem reduce bacterial infection of the pancreas. Extrapancreatic infection, however, is reduced significantly only by early antibiotic treatment. The effectivity of early antibiotic treatment in the clinical setting should be subject to further investigation with improved study design and sufficient patient numbers.

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Authors and Affiliations

  1. Department of General Surgery, University of Ulm, Ulm, Germany

    Michael Schwarz, Bertram Poch, Rainer Isenmann, Dietrich Kriese, Hans G. Beger & Frank Gansauge

  2. Department of Medical Microbiology and Hygiene, University of Ulm, Ulm, Germany

    Eva Rozdzinski

  3. Zentrum für onkologische, endokrinologische und minimalinvasive Chirurgie, Silcherstr. 36, 89231, Neu-Ulm, Germany

    Michael Schwarz

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  1. Michael Schwarz
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  2. Bertram Poch
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  3. Rainer Isenmann
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  6. Hans G. Beger
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Correspondence to Michael Schwarz.

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Schwarz, M., Poch, B., Isenmann, R. et al. Effect of early and late antibiotic treatment in experimental acute pancreatitis in rats. Langenbecks Arch Surg 392, 365–370 (2007). https://doi.org/10.1007/s00423-007-0166-5

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  • DOI: https://doi.org/10.1007/s00423-007-0166-5

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