Researchers speculate that the antioxidant properties of some drugs may be responsible for improved patient outcomes. This regimen was designed to eliminate aerobic Gram-negative bacteria, based on the theory that acute pancreatitis promotes bacterial translocation and infection of the pancreas and peripancreatic tissue. However, a recent study showed that imipenem, ofloxacin, ciprofloxacin, and cefotaxime are the drugs of choice, and that aminoglycosides, which often are used in patients with pancreatitis, did not reach levels therapeutic enough to treat infection. 7 Selected decontamination of the gut may be associated with a reduction in respiratory tract infections, which in turn reduces mortality. Nutritional support Many patients with pancreatitis are nutritionally depleted before the initial diagnosis, and the increased metabolic demands of illness prolong a negative nitrogen balance.
Nutritional support is essential, but the best route remains controversial.
Experts previously thought that parenteral nutrition was the only way to feed a patient with pancreatitis. Complete bowel rest was the gold standard. Recent reports comparing enteral versus parenteral nutrition have found jejunal enteral feedings to be a safe and effective feeding method for the patient with pancreatitis. Others have noted a decreased rate of septic complications, as well as a decrease in total complications, along with a substantial cost savings when using the gut as a nutritional route. Pancreatic and peritoneal irritation cause abdominal pain that may be complicated by presence of an abscess or pseudocyst.