Romanian Society of Pharmaceutical Sciences
 

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ANTIBIOTIC THERAPY STRATEGIES IN ACUTE BILIARY PANCREATITIS: A RETROSPECTIVE COHORT STUDY

ANA-LAURA DIMA 1,2, ANA-LAURA MANDA 3, TUDOR-ION NASTASESCU 4*, DANIEL IULIAN VOICULESCU ¹

¹ Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2 Department of Surgery, Doctoral School, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
3 1 st Surgery Clinic, Emergency University Hospital Bucharest, Romania
4 Department of Surgery, Tulcea County Emergency Hospital, Romania

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Antibiotic therapy in acute biliary pancreatitis remains debated, as early pancreatic inflammation is frequently sterile and cur- rent guidance supports antimicrobials only for confirmed or strongly suspected infection. We performed a retrospective obser- vational analysis of 139 patients with acute pancreatic pathology of biliary aetiology to describe real-world antibiotic strategies and their association with markers of severity. Antibiotics were administered in 83.5% of cases. Antibiotic exposure was asso- ciated with higher admission leukocyte count (p = 0.002), amylase (p = 0.014), lipase (p = 0.03), total bilirubin (p = 0.008), direct bilirubin (p = 0.022), and longer length of stay (median 12 versus 9 days; p = 0.018). Among treated patients, car- bapenem-based regimens (n = 32) were associated with ICU admission more frequently than non-carbapenem regimens (34.4% versus 14.3%; p = 0.02) and with lower total bilirubin (p = 0.024), while length of stay did not differ significantly (p = 0.26). Overall, antibiotic escalation appears to reflect perceived clinical severity, highlighting the importance of targeted antibiotic prescribing and stewardship.