Seven randomised controlled trials (RCTs) were included for the review (n=429 patients); two placebo-controlled double-blind RCTs (n=176 patients) and five unblinded RCTs (n=253 patients).
Prophylactic antibiotics were not associated with a reduction in the risk of infected pancreatic necrosis (odds ratio 0.72, 95% confidence interval (CI): 0.45 to 1.16; seven RCTs, n=429 patients), mortality (odds ratio 0.71, 95% CI: 0.41 to 1.23; seven RCTs, n=429 patients) or surgical intervention (odds ratio 0.82, 95% CI: 0.52 to 1.30; six RCTs, n=403 patients) compared to no treatment.
Prophylactic antibiotic use was associated with a significant decrease in the incidence of non-pancreatic infections (odds ratio 0.51, 95% CI: 0.32 to 0.82; five RCTs, n=334 patients) and length of hospital stay (weighted mean difference -5.64, 95% CI: -11.01 to -0.27; three RCTs, n=153 patients).
There was no evidence of significant statistical heterogeneity for any outcomes. There was no evidence of publication bias.