Antibiotic Use in Mild Acute Pancreatitis - Abstract
Objective: To find out the incidence of antibiotic use in mild acute pancreatitis using BISAP
(Bedside Index of Severity in Acute Pancreatitis) score and to compare the rate of antibiotic
usage between an academic tertiary care institution(ATCI)and its community hospital division (CHD).
Materials and methods: Retrospective data was analyzed using electronic medical records
from the ATCI and the CHD in Philadelphia, Pennsylvania. Patients aged >18 years irrespective of race and sex with documented mild acute pancreatitis (BISAP 0 to 3) admitted between June, 2011 to June, 2013 were included in the study. Patients with biliary obstruction, cholangitis or other source of comorbid infection for which antibiotics could reasonably be administered were excluded from the study.
Data analysis was done by Microsoft excel software and Z score calculator.
Results: 468 available charts were reviewed, 288 patients (179 from ATCI and 109 from CHD) met the study inclusion criteria. Mean age was 51.7 years, 43.5% were male and 56.5% were female. In total, 32.3% of patients with the diagnosis of mild acute pancreatitis irrespective of etiology received antibiotics. At ATCI, 46 out of 179 (probability =0.257) [1] patients received antibiotics while at CHD, 47 out of 109 (probability = 0.431) patients received antibiotics. There was a significant difference on antibiotic usage (z = -3.0, p <0.05) between the hospital sites.
Conclusion: About one third of patients with mild acute pancreatitis received antibiotics.
There was an increasing trend towards antibiotic use with increasing BISAP score. There was a significant difference in antibiotic usage between an academic tertiary care institution and a community hospital, with patients at the community hospital being more likely to receive antibiotics for mild acute pancreatitis.