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001-es BibID:BIBFORM079249
Első szerző:Párniczky Andrea (gyermekgyógyász)
Cím:Antibiotic therapy in acute pancreatitis : from global overuse to evidence based recommendations / Andrea Parniczky, Tamas Lantos, Eszter Margit Toth, Zsolt Szakacs, Szilard Godi, Roland Hagendorn, Dora Illes, Balazs Koncz, Katalin Marta, Alexandra Miko, Dora Mosztbacher, Balazs Csaba Nemeth, Daniel Pecsi, Aniko Szabo, Akos Szücs, Peter Varjú, Andrea Szentesi, Erika Darvasi, Balint Eross, Ferenc Izbeki, Laszlo Gajdan, Adrienn Halasz, Aron Vincze, Imre Szabo, Gabriella Par, Judit Bajor, Patrícia Sarlos, Jozsef Czimmer, Jozsef Hamvas, Tamas Takacs, Zoltan Szepes, Laszlo Czako, Marta Varga, Janos Novak, Barnabas Bod, Attila Szepes, Janos Sümegi, Maria Papp, Csaba Gog, Imola Torok, Wei Huang, Qing Xia, Ping Xue, Weiqin Li, Weiwei Chen, Natalia V. Shirinskaya, Vladimir L. Poluektov, Anna V. Shirinskaya, Péter Jenő Hegyi, Marian Batovský, Juan Armando Rodriguez-Oballe, Isabel Miguel Salas, Javier Lopez-Diaz, J. Enrique Dominguez-Munoz, Xavier Molero, Elizabeth Pando, María Lourdes Ruiz-Rebollo, Beatriz Burgueno-Gomez, Yu-Ting Chang, Ming-Chu Chang, Ajay Sud, Danielle Moore, Robert Sutton, Amir Gougol, Georgios I. Papachristou, Yaroslav Mykhailovych Susak, Illia Olehovych Tiuliukin, Antonio Pedro Gomes, Maria Jesus Oliveira, David Joao Aparício, Marcel Tantau, Floreta Kurti, Mila Kovacheva-Slavova, Stephanie-Susanne Stecher, Julia Mayerle, Goran Poropat, Kshaunish Das, Marco Vito Marino, Gabriele Capurso, Ewa Małecka-Panas, Hubert Zatorski, Anita Gasiorowska, Natalia Fabisiak, Piotr Ceranowicz, Beata Kusnierz-Cabala, Joana Rita Carvalho, Samuel Raimundo Fernandes, Jae Hyuck Chang, Eun Kwang Choi, Jimin Han, Sara Bertilsson, Hanaz Jumaa, Gabriel Sandblom, Sabite Kacar, Minas Baltatzis, Aliaksandr Vladimir Varabei, Vizhynis Yeshy, Serge Chooklin, Andriy Kozachenko, Nikolay Veligotsky, Peter Jr. Hegyi, Hungarian Pancreatic Study Group
Dátum:2019
ISSN:1424-3903
Megjegyzések:Background: Unwarranted administration of antibiotics in acute pancreatitis presents a global challenge. The clinical reasoning behind the misuse is poorly understood. Our aim was to investigate current clinical practices and develop recommendations that guide clinicians in prescribing antibiotic treatment in acute pancreatitis. Methods: Four methods were used. 1) Systematic data collection was performed to summarize current evidence; 2) a retrospective questionnaire was developed to understand the current global clinical practice; 3) five years of prospectively collected data were analysed to identify the clinical parameters used by medical teams in the decision making process, and finally; 4) the UpToDate Grading of Rec- ommendations, Assessment, Development and Evaluation (GRADE) system was applied to provide evi- dence based recommendations for healthcare professionals. Results: The systematic literature search revealed no consensus on the start of AB therapy in patients with no bacterial culture test. Retrospective data collection on 9728 patients from 22 countries indicated a wide range (31e82%) of antibiotic use frequency in AP. Analysis of 56 variables from 962 patients showed that clinicians initiate antibiotic therapy based on increased WBC and/or elevated CRP, lipase and amylase levels. The above mentioned four laboratory parameters showed no association with infection in the early phase of acute pancreatitis. Instead, procalcitonin levels proved to be a better biomarker of early infection. Patients with suspected infection because of fever had no benefit from antibiotic therapy. Conclusions: The authors formulated four consensus statements to urge reduction of unjustified anti- biotic treatment in acute pancreatitis and to use procalcitonin rather than WBC or CRP as biomarkers to guide decision-making.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Acute pancreatitis
Antibiotic
Guideline
Recommendation
Infection
Megjelenés:Pancreatology. - 19 : 4 (2019), p. 488-499. -
További szerzők:Lantos Tamás Tóth Eszter Margit Szakács Zsolt Gódi Szilárd Hágendorn Roland Illés Dóra Koncz Balázs Márta Katalin Mikó Alexandra Mosztbacher Dóra Németh Balázs Csaba Pécsi Dániel Szabó Anikó Szűcs Ákos (sebész) Varjú Péter Szentesi Andrea Darvasi Erika Erőss Bálint Izbéki Ferenc Gajdán László Halász Adrienn Vincze Áron Szabó Imre (1952-) (orvos) Pár Gabriella Bajor Judit Sarlós Patrícia Czimmer József Hamvas József Takács Tamás (Szeged) Szepes Zoltán Czakó László Varga Márta Novák János Bod Barnabás Szepes Attila Sümegi János Papp Mária (1975-) (belgyógyász, gasztroenterológus) Góg Csaba Török Imola Huang, Wei Xia, Qing Xue, Ping Li, Weiqin Chen, Weiwei Shirinskaya, Natalia V. Poluektov, Vladimir L. Shirinskaya, Anna V. Hegyi Péter Jenő (belgyógyász) Bátovský, Marian Rodriguez-Oballe, Juan Armando Salas, Isabel Miguel Lopez-Diaz, Javier Dominguez-Munoz, J. Enrique Molero, Xavier Pando, Elizabeth Ruiz-Rebollo, María Lourdes Burgueño-Gómez, Beatriz Chang, Yu-Ting Chang, Ming-Chu Sud, Ajay Moore, Danielle Sutton, Robert Gougol, Amir Papachristou, Georgios I. Susak, Yaroslav Mykhailovych Tiuliukin, Illia Olehovych Gomes, António Pedro Oliveira, Maria Jesus Aparício, David João Tantau, Marcel Kurti, Floreta Kovacheva-Slavova, Mila Stecher, Stephanie-Susanne Mayerle, Julia Poropat, Goran Das, Kshaunish Marino, Marco Vito Capurso, Gabriele Małecka-Panas, Ewa Zatorski, Hubert Gasiorowska, Anita Fabisiak, Natalia Ceranowicz, Piotr Kuśnierz-Cabala, Beata Carvalho, Joana Rita Fernandes, Samuel Raimundo Chang, Jae Hyuck Choi, Eun Kwang Han, Jimin Bertilsson, Sara Jumaa, Hanaz Sandblom, Gabriel Kacar, Sabite Baltatzis, Minas Varabei, Aliaksandr Vladimir Yeshy, Vizhynis Chooklin, Serge Kozachenko, Andriy Veligotsky, Nikolay Hegyi Péter Jr. (belgyógyász) Hungarian Pancreatic Study Group
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