Effect of different regimens of gut decontamination on bacterial translocation and mortality in experimental acute pancreatitis

Objective: To assess the effect of four regimens of antibiotics (compared with a control regimen of distilled water) given orally on gut decontamination, bacterial translocation, and mortality in acute necrotising pancreatitis in mice. Design: Randomised experimental study. Setting: University hospitals, USA and Italy. Materials: 150 young Swiss Webster mice. Intervention: All mice were fed a diet deficient in choline and supplemented with ethionine. They were then randomised to be given by gavage (36 hours after starting the diet): distilled water (controls, group 1); aztreonam alone (group 2); neomycin, erythromycin, metronidazole (group 3); polymyxin B and amikacin (group 4); polymyxin B, amikacin, amphotericin B (group 5). 20 Mice in each group were treated for 10 days, and the remaining 10 in each group were killed after 3 days. Main outcome measures: Survival, and qualitative and quantitative cultures of the liver, lungs, pancreas and caecum. Results: The best survival rate durin...