The Use of Prophylaxis Antibiotics to Prevent Acute Pancreatitis Complications: Meta-Analysis of Clinical Trials.

Background: Acute pancreatitis (AP) is an inflammation ofthe pancreas, a serious emergency with no definitive treatment. It may progress to infected necrosis, non-pancreatitis infection, also death that may occur within the first 1 to 2 weeks. The use of prophylactic antibiotics in AP to prevent complications remains a controversy. The objective of this meta-analysis is to assess the benefit ofprophylaxis antibiotics administration to prevent the complication. Method: Trials were identified by searching the medical database. Literature range is within the year 1975 to 2021. Review Manager 5.4.1 was used to analyse data extraction and risk of bias of included studies were elaborated. Riskratio (RR) was calculatedwith 95% confidence interval (CI). P<0.05 was considered significant. Results: Twenty trials with a total of1.287patients ofAP were analysed; 646patients treated with antibiotic prophylaxis and 641 patients treated with placebo. Prophylaxis antibiotics werefound to have significant difference between the two groups. The administration of prophylaxis antibiotics lower the risk of non-pancreatic infections (RR = 0.77; 95% CI: 0.62-0.95; p < 0.05) and infected pancreatic necrosis (RR = 0.74; 95% CI: 0.58-0.94; p < 0.05). Meanwhile, prophylaxis antibiotics were found to be insignificant to lower the risk of mortality (RR = 0.75; 95% CI: 0.54-1.03;p > 0.05). Conclusion: Prophylaxis antibiotics lower the risk of non-pancreatic infections and infected pancreatic necrosis, but did not lower the risk of mortality. [ABSTRACT FROM AUTHOR]

Latar belakang: Pankreatitis Akut (PA) adalah inflamasi pada pancreas, kondisi emergensi tanpa pengobatan definitive. Hal ini dapat berkembang menjadi nekrosis yang terinfeksi, infeksi non-pankreatitis, juga kematian yang terjadi dalam satu sampai dua minggu pertama. Penggunaan antibiotic sebagai profilaksis terhadap PA dalam mencegah terjadinya komplikasi masih kontroversi. Tujuan dari meta-analisis ini adalah untuk menilai keuntungan pemberian profilaksis antibiotic dalam mencegah terjadinya komplikasi. Metode: Pencarian uji klinis melalui database medis. Rentang literature antara tahun 1975 sampai 2021. Review Manager 5.4.1 digunakan dalam menganalisa data yang diesktraksi dan risiko bias dari studi yang dilibatkan. Risiko rasio (RR) dihitung dengan interval kepercayaan 95% Cl. Nilai p <0.05 dianggap signifikan. Hasil: Dua puluh uji klinis dengan total 1.287pasien dari PA dianalisa; 646 pasien diberikan profilaksis antibiotik dan 641 pasien diberikan placebo. Profilaksis antibiotik menunjukkan hasil yang signifikan pada kedua grup. Pemberian profilaksis antibiotic menurunkan risiko dari infeksi non-pankreatitis (RR = 0.77; 95% Cl: 0.62-0.95; p < 0.05) dan nekrosis pancreas yang terinfeksi (RR = 0.74; 95% Cl: 0.58-0.94; p < 0.05). Sementara itu, profilaksis antibiotic menunjukkan hasil yang tidak signifikan dalam menurunkan risiko dari kematian (RR = 0.75; 95% Cl: 0.54-1.03;p > 0.05). Simpulan: Profilaksis antibiotik menurunkan risiko infeksi non-pankreas dan nekrosis pankreas yang terinfeksi, tetapi tidak menurunkan risiko kematian. [ABSTRACT FROM AUTHOR]

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