- Antibiotics should be used in any case of pancreatitis complicated by infected pancreatic necrosis but should not be given routinely for fever, especially early in the presentation:
- Carbapenem usually the best class due to penetration in to pancreatic tissue
- Fungal infection should be considered in severe infected pancreatic necrosis
- Image-guided FNA should be used to gain material for culture when:
- Necrosis and features of sepsis
- 30% necrosis and persistent symptoms at 7-14 days
- Antibiotic prophylaxis in severe pancreatitis is controversial:
- Trials performed in this area show great heterogeneity with a variety of antibiotics used for different durations
- Routine use of against infection is not currently recommended
- If used may increase the risk of fungal superinfection