Except for a minority of early fatalities, most deaths in acute pancreatitis occur after the first 7 to 10 days due to infective complications, particularly infected necrosis. Hence, preventing this risk factor seems to represent a major step forward in the clinical management of severe pancreatitis. Consequently, antibiotics emerged as a cornerstone of the treatment of severe acute pancreatitis. The duration of such treatment, the route of administration and the substance(s) of choice need to be carefully selected. Surgical debridement is the treatment of choice of infected necrosis, while percutaneous drainage is successful in some patients.
Copyright 2002 Elsevier Science Ltd.