P0062 - Antibiotic Therapy is Associated with Greater Length of Stay in Mild and Moderate Pancreatitis

Neil Gambhir, DO¹, Dhruv Shankar, MD², Peter Bhandari, MD¹, Samantha Rubin, DO¹, Jonathan Jeong, DO¹, Jeffrey Dong, MD³, Tasnin Khan, DO¹, Aditya Sreenivasan, MD^1
1Lenox Hill Hospital, Northwell Health, New York, NY; ²University of Washington, New York, NY; ³Lenox Hill Hospital, Northwell Health, Long Island City, NY

Introduction: Acute Pancreatitis (AP) is one of the most common gastrointestinal conditions and is responsible for over 250,000 admissions and $2.5 billion in healthcare expenditure annually within the United States. While early recognition and treatment has led to a decrease in mortality, many patients are empirically started on antibiotics without guidelines to support their use. This study seeks to analyze patients treated for AP with and without antibiotics to evaluate their effect on relevant metrics such as length of stay (LOS) and mortality.

Methods: Retrospective chart review identified patients who presented with AP from 2015-2021. Patients were placed into two cohorts; P-ABX for those who received antibiotics and P-C for those who did not. Data abstracted included baseline demographics, pancreatitis etiology, LOS, mortality, and escalation of care to intensive care units. Pancreatitis grade (mild/moderate/severe) was determined using the modified Atlanta criterion and patients with severe pancreatitis were excluded. Statistical analysis was conducted and p-values < 0.05 were considered statistically significant.

Results: A total of 357 patients (P-ABX = 75 and P-C = 282) were included in this study (Table 1). The P-ABX group featured a significantly higher percentage of patients with moderate pancreatitis (24% vs 10.6% p <0.001) and gallstone pancreatitis (62.7% vs 22.3% p< 0.001). LOS was greater in the P-ABX group (6.5 ± 5.8 vs 4.1 ± 5.5 p< 0.001). Subgroup analysis conducted on patients with gallstone pancreatitis demonstrated greater LOS in the antibiotic group (6.1 ± 4.2 P-ABX vs 5.6 ± 8.2 P-C p=0.008) with no differences in pancreatitis grade. Additional subgroup analysis on patients with mild pancreatitis only also showed greater LOS in the antibiotic group (5.3 ± 3.0 P-ABX vs. 4.0 ± 5.8 P-C p< 0.001). Overall, there were no significant differences in escalation of care or mortality between cohorts.

Discussion: This study demonstrates that antibiotic therapy is associated with increased LOS in cases of mild and moderate pancreatitis. This association persisted in subgroup analyses of mild pancreatitis and gallstone pancreatitis. In an age of growing antimicrobial resistance and hospital acquired infections, this study indicates that empiric antibiotic use in AP may contribute to unnecessary healthcare expenditure without clinical benefit.


Disclosures:


Neil Gambhir, DO¹, Dhruv Shankar, MD², Peter Bhandari, MD¹, Samantha Rubin, DO¹, Jonathan Jeong, DO¹, Jeffrey Dong, MD³, Tasnin Khan, DO¹, Aditya Sreenivasan, MD¹. P0062 - Antibiotic Therapy is Associated with Greater Length of Stay in Mild and Moderate Pancreatitis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.