ABSTRACT:
The present study focussed on the clinical profile of patients with acute severe pancreatitis on carbapenem Vs non carbapenems. Out of 55 patients 22 patients were given carbapenem antibiotics and rest were given non carbapenem antibiotics which comprises of cephalosporins, fluoroquinolones, Piperacillin +tazobactum, Metronidazole. In the carbapenem group 20 patients were initially on cephalosporins and later they were started on carbapenem as they were not improving. In these 20 patients, renal failure is observed in 14 patients and respiratory failure in 6 patients. All these 20patients survived and they stayed in hospital for 3-5weeks.Two patients in carbapenem group died and they had renal and respiratory failure even they were started on carbapenem in the first week. These two patients stayed in hospital for 3weeks. A total of 33 patients were given non carbapenem antibiotics. Out of 33patients 16patients had renal failure and 12patients had multiorgan failure. 8patients had local complications in form of multiple fluid collections and necrosis more than 50%. 22out of patients received cefaperazone+sulbactum with Fluoroquinolones. 7 patients received only Piperacillin+Tazobactum with Fluoroquinolones. 4 patients received only Fluoroquinolones. 30patients who were on cephalosporins stayed 2-3weeks and all 30 patients improved and were discharged. 3 Patients out of 33 died in the first week due to multiorgan failure. This study conclude that cefaperazone sulbactum along with quinolone is a good first choice antibiotic and reserve the imipenem for sicker and non responders to cephalosporins.