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. 1981 May;193(5):649–654. doi: 10.1097/00000658-198105000-00016

Effect of bile induced pancreatitis on tobramycin excretion in pancreatic fluid.

J G Studley, J J Schentag, W G Schenk Jr
PMCID: PMC1345140  PMID: 7235768

Abstract

The objective of this study has been to lay the groundwork for a re-evaluation of the place of antibiotics in acute pancreatitis. This section has been devoted to determining if antibiotics excreted by the normal pancreas are excreted similarly in acute pancreatitis. Ten mongrel dogs were studied, each acting as its own control. Day 1: Operation--construction of pancreatic fistula. Day 2: Study of antibiotic excretion. Day 14: Operation--induction of acute focal pancreatitis. Day 15: Study of antibiotic excretion. Antibiotic concentrations in pancreatic fluid were studied by injecting tobramycin intravenously (5 mg/kg). Serum levels and excretion of the drug in the pancreatic secretion were then monitored over the next six hours. Results showed excretion of tobramycin reached bactericidal concentrations in pancreatic fluid from the normal and inflamed pancreas, with no significant differences (p = 0.2) between the excretion rates. The place of antibiotics in acute pancreatitis is discussed. Based on usual pathogens isolated in pancreatic abscesses, and their usual sensitivity patterns, tobramycin with Cephamandole are the antibiotics of choice in acute pancreatitis, and a clinical trial is indicated to evaluate their place in reducing complications and deaths in the disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALTEMEIER W. A., ALEXANDER J. W. Pancreatic abscess. A study of 32 cases. Arch Surg. 1963 Jul;87:80–89. doi: 10.1001/archsurg.1963.01310130082011. [DOI] [PubMed] [Google Scholar]
  2. BYRNE J. J., JOISON J. BACTERIAL REGURGITATION IN EXPERIMENTAL PANCREATITIS. Am J Surg. 1964 Feb;107:317–320. doi: 10.1016/0002-9610(64)90274-0. [DOI] [PubMed] [Google Scholar]
  3. Bilbao M. K., Dotter C. T., Lee T. G., Katon R. M. Complications of endoscopic retrograde cholangiopancreatography (ERCP). A study of 10,000 cases. Gastroenterology. 1976 Mar;70(3):314–320. [PubMed] [Google Scholar]
  4. Bolooki H., Jaffe B., Gliedman M. L. Pancreatic abscesses and lesser omental sac collections. Surg Gynecol Obstet. 1968 Jun;126(6):1301–1308. [PubMed] [Google Scholar]
  5. Elson C. O., Hattori K., Blackstone M. O. Polymicrobial sepsis following endoscopic retrograde cholangiopancreatography. Gastroenterology. 1975 Aug;69(2):507–510. [PubMed] [Google Scholar]
  6. Evans F. C. Pancreatic abscess. Am J Surg. 1969 Apr;117(4):537–540. doi: 10.1016/0002-9610(69)90013-0. [DOI] [PubMed] [Google Scholar]
  7. Farringer J. L., Jr, Robbins L. B., 2nd, Pickens D. R., Jr Abscesses of the pancreas. Surgery. 1966 Nov;60(5):964–970. [PubMed] [Google Scholar]
  8. Gregg J. A. Detection of bacterial infection of the pancreatic ducts in patients with pancreatitis and pancreatic cancer during endoscopic cannulation of the pancreatic duct. Gastroenterology. 1977 Nov;73(5):1005–1007. [PubMed] [Google Scholar]
  9. Herrera F., Kemp D. R., Tsukamoto M., Woodward E. R., Dragstedt L. R. A new cannula for the study of pancreatic function. J Appl Physiol. 1968 Aug;25(2):207–209. doi: 10.1152/jappl.1968.25.2.207. [DOI] [PubMed] [Google Scholar]
  10. Howes R., Zuidema G. D., Cameron J. L. Evaluation of prophylactic antibiotics in acute pancreatitis. J Surg Res. 1975 Feb;18(2):197–200. doi: 10.1016/0022-4804(75)90016-5. [DOI] [PubMed] [Google Scholar]
  11. Imrie C. W., McKay A. J., Benjamin I. S., Blumgart L. H. Secondary acute pancreatitis: aetiology, prevention, diagnosis and management. Br J Surg. 1978 Jun;65(6):399–402. doi: 10.1002/bjs.1800650609. [DOI] [PubMed] [Google Scholar]
  12. Jendrzejewski J. W., McAnally T., Jones S. R., Katon R. M. Antibiotics and ERCP: in vitro activity of aminoglycosides when added to iodinated contrast agents. Gastroenterology. 1980 Apr;78(4):745–748. [PubMed] [Google Scholar]
  13. Jones C. E., Polk H. C., Jr, Fulton R. L. Pancreatic abscess. Am J Surg. 1975 Jan;129(1):44–47. doi: 10.1016/0002-9610(75)90165-8. [DOI] [PubMed] [Google Scholar]
  14. Kodesch R., DuPont H. L. Infectious complications of acute pancreatitis. Surg Gynecol Obstet. 1973 May;136(5):763–768. [PubMed] [Google Scholar]
  15. Miller T. A., Lindenauer S. M., Frey C. F., Stanley J. C. Proceedings: Pancreatic abscess. Arch Surg. 1974 Apr;108(4):545–551. doi: 10.1001/archsurg.1974.01350280147024. [DOI] [PubMed] [Google Scholar]
  16. Nugent F. W. Medical management of acute pancreatitis. Med Clin North Am. 1969 Mar;53(2):431–435. [PubMed] [Google Scholar]
  17. PRESTON F. W., SILVERMAN M., HENEGAR G. C. Excretion of antibiotics in pancreatic fluid. AMA Arch Surg. 1959 May;78(5):810–814. doi: 10.1001/archsurg.1959.04320050141021. [DOI] [PubMed] [Google Scholar]
  18. Schentag J. J., Lasezkay G., Cumbo T. J., Plaut M. E., Jusko W. J. Accumulation pharmacokinetics of tobramycin. Antimicrob Agents Chemother. 1978 Apr;13(4):649–656. doi: 10.1128/aac.13.4.649. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Stefanini P., Ermini M., Carboni M. Diagnosis and management of acute pancreatitis. Am J Surg. 1965 Dec;110(6):866–875. doi: 10.1016/0002-9610(65)90171-6. [DOI] [PubMed] [Google Scholar]
  20. Williams L. F., Jr, Byrne J. J. The role of bacteria in hemorrhagic pancreatitis. Surgery. 1968 Nov;64(5):967–972. [PubMed] [Google Scholar]

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