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Antimicrobials
Infection develops in 30-50% of patients with necrosis documented by CT scan or at the time of surgery.
Peak incidence of infection occurs in the 3rd week of disease.
Prophylactic antibiotics have been associated with a change in the spectrum of pancreatic isolates from enteric Gram-negatives to Gram-positive organisms and fungi.
There is insufficient evidence to recommend selective gut decontamination in management of pancreatitis.