Impact of Antimicrobial Prophylaxis for Severe Acute Pancreatitis on the Development of Invasive Candidiasis: A Large Retrospective Multicenter Cohort Study.

Authors:
Masayasu Horibe
Masayasu Horibe
Toki General Hospital
Masamitsu Sanui
Masamitsu Sanui
Jichi Medical University
Japan
Mitsuhito Sasaki
Mitsuhito Sasaki
National Cancer Center Hospital
Hitoshi Honda
Hitoshi Honda
Washington University School of Medicine
Yuki Ogura
Yuki Ogura
Waseda University
Japan
Shin Namiki
Shin Namiki
Tokyo Metropolitan Tama Medical Center
Hirotaka Sawano
Hirotaka Sawano
Osaka Saiseikai Senri Hospital
Japan
Takashi Goto
Takashi Goto
Akita University School of Medicine

Pancreas 2019 04;48(4):537-543

Department of Emergency Medicine, School of Medicine University of Occupational and Environmental Health, Fukuoka, Japan.

Objective: Antimicrobial prophylaxis is not generally recommended for patients with severe acute pancreatitis (SAP) owing to the limited clinical benefits. Nonetheless, it is frequently administered in actual practice given the patients' critical condition and the lack of solid evidence showing adverse effects of antimicrobial prophylaxis. We evaluated herein an association between antimicrobial prophylaxis and invasive pancreatic candidiasis as an adverse effect in patients with SAP.

Methods: This is a retrospective cohort study of all consecutive patients with SAP who were admitted to the study institutions (n = 44) between January 1, 2009, and December 31, 2013. We performed multivariable logistic regression analysis adjusting for the extent of pancreatic necrosis and surgical interventions for invasive pancreatic candidiasis.

Results: Of the 1097 patients with SAP, 850 (77.5%) received antimicrobial prophylaxis, and 21 (1.9%) had invasive pancreatic candidiasis. In multivariable logistic regression analysis, antimicrobial prophylaxis was significantly associated with the development of invasive pancreatic candidiasis (adjusted odds ratio, 4.23; 95% confidence interval, 1.14-27.6) (P = 0.029).

Conclusions: The results suggest that antimicrobial prophylaxis may contribute to the development of invasive pancreatic candidiasis, and therefore, the routine use of antimicrobial prophylaxis for SAP may be discouraged.

Download full-text PDF

Source
http://dx.doi.org/10.1097/MPA.0000000000001269DOI Listing

Still can't find the full text of the article?

We can help you send a request to the authors directly.
April 2019
11 Reads

Publication Analysis

Top Keywords

antimicrobial prophylaxis
32
invasive pancreatic
20
pancreatic candidiasis
16
development invasive
12
acute pancreatitis
8
logistic regression
8
regression analysis
8
multivariable logistic
8
prophylaxis
8
severe acute
8
patients sap
8
cohort study
8
antimicrobial
7
invasive
6
pancreatic
6
candidiasis
5
december 2013
4
pancreatic necrosis
4
necrosis surgical
4
2009 december
4

Similar Publications