{"id":10014,"date":"2025-06-26T06:30:00","date_gmt":"2025-06-26T09:30:00","guid":{"rendered":"https:\/\/gastropedia.pub\/pt\/?p=10014"},"modified":"2025-06-27T15:05:56","modified_gmt":"2025-06-27T18:05:56","slug":"pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico","status":"publish","type":"post","link":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/","title":{"rendered":"Pancreatite Aguda &#8211; Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico?"},"content":{"rendered":"<div class=\"pdfprnt-buttons pdfprnt-buttons-post pdfprnt-top-right\"><a href=\"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/10014?print=pdf\" class=\"pdfprnt-button pdfprnt-button-pdf\" target=\"_blank\" ><img decoding=\"async\" src=\"https:\/\/gastropedia.pub\/pt\/wp-content\/plugins\/pdf-print\/images\/pdf.png\" alt=\"image_pdf\" title=\"Ver PDF\" \/><\/a><a href=\"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/10014?print=print\" class=\"pdfprnt-button pdfprnt-button-print\" target=\"_blank\" ><img decoding=\"async\" src=\"https:\/\/gastropedia.pub\/pt\/wp-content\/plugins\/pdf-print\/images\/print.png\" alt=\"image_print\" title=\"Conte\u00fado de impress\u00e3o\" \/><\/a><\/div>\n<p>Voltamos com mais uma controv\u00e9rsia em pancreatite aguda (voc\u00eas podem ler sobre outras controv\u00e9rsias em <a href=\"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-i-qual-a-melhor-maneira-de-predizer-a-gravidade\/\">Pancreatite Aguda \u2013 Controv\u00e9rsias Parte I: Qual a melhor maneira de predizer a gravidade?<\/a> e <a href=\"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-ii-como-realizar-a-hidratacao\/\">Pancreatite Aguda \u2013 Controv\u00e9rsias Parte II: Como realizar a hidrata\u00e7\u00e3o<\/a>), e essa talvez seja uma das mais discutidas.<\/p>\n\n\n\n<p>Durante muitos anos, recomendou-se o uso profil\u00e1tico de antibi\u00f3ticos em casos de pancreatite aguda, especialmente nas formas graves, com o objetivo de prevenir a infec\u00e7\u00e3o do tecido necr\u00f3tico. Essa pr\u00e1tica foi inicialmente sustentada por estudos cl\u00ednicos e metan\u00e1lises que sugeriam redu\u00e7\u00e3o na taxa de infec\u00e7\u00e3o e, em alguns casos, tamb\u00e9m na mortalidade. <strong>Entretanto novos estudos foram realizados, e essa determina\u00e7\u00e3o foi revista.<\/strong><\/p>\n\n\n\n<p>Para entender as recomenda\u00e7\u00f5es, <strong>\u00e9 necess\u00e1rio entender a fisiopatologia da pancreatite aguda<\/strong>. A doen\u00e7a tem <strong>duas fases distintas<\/strong>, que podem se sobrepor.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A <strong>primeira fase \u00e9 a chamada fase inflamat\u00f3ria<\/strong>, que leva de 7-10 dias, em que as altera\u00e7\u00f5es inflamat\u00f3rias s\u00e3o decorrentes da cascata de citocinas. O quadro cl\u00ednico \u00e9 o da S\u00edndrome da Resposta Inflamat\u00f3ria Sist\u00eamica (SIRS), e na presen\u00e7a de SIRS \u00e9 onde est\u00e1 o risco de disfun\u00e7\u00e3o org\u00e2nica. Nesta fase a forma\u00e7\u00e3o de complica\u00e7\u00f5es locais (como necrose pancre\u00e1tica ou cole\u00e7\u00f5es fluidas) n\u00e3o \u00e9 determinante para o progn\u00f3stico.<\/li>\n\n\n\n<li>A <strong>segunda fase (ou fase tardia) <\/strong>ocorre ap\u00f3s 10-14 dias, e \u00e9 nesta fase que as complica\u00e7\u00f5es locais (como necrose ou cole\u00e7\u00f5es) evoluem e aumentam o <strong>risco de infec\u00e7\u00e3o<\/strong>. Al\u00e9m disso, devido a altera\u00e7\u00e3o de permeabilidade intestinal, aumenta tamb\u00e9m o risco de infec\u00e7\u00f5es extra-pancre\u00e1ticas. A presen\u00e7a de sinais inflamat\u00f3rios alterados ou SIRS nessa fase tardia sugerem poss\u00edvel foco infeccioso.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/gastropedia.pub\/pt\/?attachment_id=10015\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"377\" src=\"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA-1024x377.png\" alt=\"\" class=\"wp-image-10015\" srcset=\"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA-1024x377.png 1024w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA-300x110.png 300w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA-768x283.png 768w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA-1536x566.png 1536w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA-1170x431.png 1170w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA-585x215.png 585w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA-1080x398.png 1080w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/FIGURA-1-MAIRA.png 1898w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/a><figcaption class=\"wp-element-caption\"><br>Figura 1. Mecanismos de Infec\u00e7\u00e3o na Pancreatite Aguda<\/figcaption><\/figure>\n\n\n\n<p>Assim, <strong>\u00e9 improv\u00e1vel que o paciente tenha infec\u00e7\u00e3o relacionada ao p\u00e2ncreas na primeira fase, sendo contra-indicado o uso de antibi\u00f3ticos neste momento<\/strong> (se houver suspeita de infec\u00e7\u00e3o extra pancre\u00e1tica, essa condi\u00e7\u00e3o deve ser pesquisada e tratada quando presente).<\/p>\n\n\n\n<p><strong>Ap\u00f3s 10-14 dias<\/strong>, no caso das pancreatites moderadamente graves e graves, <strong>pode haver forma\u00e7\u00e3o de tecido necr\u00f3tico<\/strong>. Neste momento podem surgir sinais e sintomas que indiquem infec\u00e7\u00e3o desse tecido. O <strong>uso de terapia com antibi\u00f3ticos deve ser considerado na suspeita ou confirma\u00e7\u00e3o de infec\u00e7\u00e3o de tecido necr\u00f3tico<\/strong>. A confirma\u00e7\u00e3o pode ser feita atrav\u00e9s de imagem (presen\u00e7a de g\u00e1s em topografia da necrose \u00e9 um sinal inequ\u00edvoco de infec\u00e7\u00e3o) ou atrav\u00e9s de exames laboratoriais e piora cl\u00ednica (febre, aumento de PCR, leucocitose, ou cultura de material com presen\u00e7a de microrganismos).<\/p>\n\n\n\n<p class=\"has-text-align-center has-very-light-gray-to-cyan-bluish-gray-gradient-background has-background\">N\u00e3o \u00e9 necess\u00e1ria confirma\u00e7\u00e3o microbiol\u00f3gica (embora seja recomend\u00e1vel) para instituir antibioticoterapia, na suspeita de infec\u00e7\u00e3o de tecido necr\u00f3tico. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-profilaxia-antibiotica\"><br><strong>Profilaxia antibi\u00f3tica<\/strong><\/h2>\n\n\n\n<p>As diretrizes e guidelines atuais <strong>n\u00e3o recomendam a administra\u00e7\u00e3o de antibi\u00f3ticos para profilaxia de infec\u00e7\u00e3o de tecido necr\u00f3tico<\/strong>. A recomenda\u00e7\u00e3o foi estabelecida ap\u00f3s a realiza\u00e7\u00e3o de estudos prospectivos, randomizados e placebo-controlados que <strong>n\u00e3o evidenciaram diferen\u00e7as entre mortalidade, infec\u00e7\u00e3o de tecido necr\u00f3tico, complica\u00e7\u00f5es sist\u00eamicas ou necessidade de interven\u00e7\u00e3o cir\u00fargica<\/strong>. Tamb\u00e9m \u00e9 contraindicada a administra\u00e7\u00e3o profil\u00e1tica de anti-f\u00fangicos.<\/p>\n\n\n\n<p>Recentemente, em um estudo observacional prospectivo indiano, os pacientes com suspeita de infec\u00e7\u00e3o de tecido necr\u00f3tico que receberam antibi\u00f3ticos na primeira semana de doen\u00e7a, tiveram maiores taxas de infec\u00e7\u00f5es com microrganismos resistentes e infec\u00e7\u00f5es f\u00fangicas.<\/p>\n\n\n\n<p class=\"has-text-align-center has-very-light-gray-to-cyan-bluish-gray-gradient-background has-background\">A profilaxia antibi\u00f3tica <strong>n\u00e3o<\/strong> \u00e9 recomendada nos casos de pancreatite aguda moderadamente grave ou grave.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-tratamento-antibiotico\"><br><strong>Tratamento antibi\u00f3tico<\/strong><\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/gastropedia.pub\/pt\/?attachment_id=10017\"><img decoding=\"async\" width=\"1024\" height=\"709\" src=\"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda-1024x709.jpeg\" alt=\"\" class=\"wp-image-10017\" srcset=\"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda-1024x709.jpeg?v=1749690392 1024w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda-300x208.jpeg?v=1749690392 300w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda-768x532.jpeg?v=1749690392 768w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda-1170x810.jpeg?v=1749690392 1170w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda-585x405.jpeg?v=1749690392 585w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda-1080x748.jpeg?v=1749690392 1080w, https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda.jpeg?v=1749690392 1259w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/a><figcaption class=\"wp-element-caption\"><br>Imagem de arquivo pessoal, autorizada pelo paciente<\/figcaption><\/figure>\n\n\n\n<p>O tratamento com antibi\u00f3ticos de amplo espectro e com boa penetr\u00e2ncia em loja pancre\u00e1tica dever\u00e1 ser iniciado na suspeita ou confirma\u00e7\u00e3o de infec\u00e7\u00e3o de s\u00edtio necr\u00f3tico. A escolha \u00e9 por carbapen\u00eamicos, quinolonas ou cefalosporinas de terceira gera\u00e7\u00e3o (que t\u00eam cobertura para germes gram negativos), embora essa cobertura possa se estender para germes gram positivos e fungos, se n\u00e3o houver resposta cl\u00ednica.<\/p>\n\n\n\n<p>No caso da resposta cl\u00ednica n\u00e3o ser adequada, se poss\u00edvel, a cultura do material necr\u00f3tico pode auxiliar no diagn\u00f3stico, e guiar a cobertura antibi\u00f3tica.<\/p>\n\n\n\n<p>E, por fim, caso haja piora cl\u00ednica, mesmo com a terapia antibi\u00f3tica institu\u00edda, o paciente dever\u00e1 ser considerado para tratamento intervencionista do tecido necr\u00f3tico, mas este assunto ser\u00e1 abordado em novo post.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-referencias\"><strong>Refer\u00eancias<\/strong><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Ukai T, Shikata S, Inoue M, Noguchi Y, Igarashi H, Isaji S, Mayumi T, Yoshida M, Takemura YC. Early prophylactic antibiotics administration for acute necrotizing pancreatitis: a meta-analysis of randomized controlled trials. J Hepatobiliary Pancreat Sci. 2015 Apr;22(4):316-21. doi: 10.1002\/jhbp.221. Epub 2015 Feb 9. PMID: 25678060.<\/li>\n\n\n\n<li>Yao L, Huang X, Li Y, et al. Prophylactic antibiotics reduce pancreatic necrosis in acute necrotizing pancreatitis: a meta-analysis of randomized trials. Dig Surg. 2010;27(6):442\u2013449<\/li>\n\n\n\n<li>Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102\u2013111<\/li>\n\n\n\n<li>Baron TH, DiMaio CJ, Wang AY, Morgan KA. American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis. Gastroenterology 2020;158:67\u201375<\/li>\n\n\n\n<li>Loganathan P, Muktesh G, Kochhar R, et al. (October 19, 2024) Natural History and Microbiological Profiles of Patients With Acute Pancreatitis With Suspected Infected Pancreatic Necrosis. Cureus 16(10): e71853.<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-como-citar-este-artigo\"><strong>Como citar este artigo<\/strong><\/h2>\n\n\n\n<p class=\"has-very-light-gray-to-cyan-bluish-gray-gradient-background has-background\">Marzinotto M. Pancreatite Aguda &#8211; Controv\u00e9rsias parte III Mas e o antibi\u00f3tico? Gastropedia 2025, Vol II. Dispon\u00edvel em: <a href=\"https:\/\/gastropedia.pub\/pt\/?p=10014\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/<\/a><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Voltamos com mais uma controv\u00e9rsia em pancreatite aguda (voc\u00eas podem ler sobre outras controv\u00e9rsias em Pancreatite Aguda \u2013 Controv\u00e9rsias Parte I: Qual a melhor maneira de predizer a gravidade? e&hellip;<\/p>\n","protected":false},"author":3341,"featured_media":10017,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[18,23],"tags":[],"ano":[413],"tipo":[121],"volume":[57],"class_list":["post-10014","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gastroenterologia","category-pancreas","ano-413","tipo-assuntos-gerais","volume-volume-i"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Pancreatite Aguda - Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico? - Gastropedia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pancreatite Aguda - Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico?\" \/>\n<meta property=\"og:description\" content=\"Voltamos com mais uma controv\u00e9rsia em pancreatite aguda (voc\u00eas podem ler sobre outras controv\u00e9rsias em Pancreatite Aguda \u2013 Controv\u00e9rsias Parte I: Qual a melhor maneira de predizer a gravidade? e&hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/\" \/>\n<meta property=\"og:site_name\" content=\"Gastropedia\" \/>\n<meta property=\"article:published_time\" content=\"2025-06-26T09:30:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-06-27T18:05:56+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda.jpeg?v=1749690392\" \/>\n\t<meta property=\"og:image:width\" content=\"1259\" \/>\n\t<meta property=\"og:image:height\" content=\"872\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Maira Marzinotto\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Maira Marzinotto\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/\"},\"author\":{\"name\":\"Maira Marzinotto\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/bc9eb1d348f7591af72ba0facb603c11\"},\"headline\":\"Pancreatite Aguda &#8211; Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico?\",\"datePublished\":\"2025-06-26T09:30:00+00:00\",\"dateModified\":\"2025-06-27T18:05:56+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/\"},\"wordCount\":944,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2025\\\/06\\\/pancreatite-aguda.jpeg?v=1749690392\",\"articleSection\":[\"Gastroenterologia\",\"P\u00e2ncreas\"],\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/\",\"name\":\"Pancreatite Aguda - Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico? - Gastropedia\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2025\\\/06\\\/pancreatite-aguda.jpeg?v=1749690392\",\"datePublished\":\"2025-06-26T09:30:00+00:00\",\"dateModified\":\"2025-06-27T18:05:56+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/bc9eb1d348f7591af72ba0facb603c11\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/#primaryimage\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2025\\\/06\\\/pancreatite-aguda.jpeg?v=1749690392\",\"contentUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2025\\\/06\\\/pancreatite-aguda.jpeg?v=1749690392\",\"width\":1259,\"height\":872},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"In\u00edcio\",\"item\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pancreatite Aguda &#8211; Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#website\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/\",\"name\":\"Gastropedia\",\"description\":\"Atualiza\u00e7\u00e3o m\u00e9dica de forma descomplicada para profissionais que trabalham com sa\u00fade do aparelho digestivo.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-BR\"},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/bc9eb1d348f7591af72ba0facb603c11\",\"name\":\"Maira Marzinotto\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"http:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/11\\\/RENOVADOmaira.jpg\",\"url\":\"http:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/11\\\/RENOVADOmaira.jpg\",\"contentUrl\":\"http:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/11\\\/RENOVADOmaira.jpg\",\"caption\":\"Maira Marzinotto\"},\"description\":\"Medica respons\u00e1vel pelo Grupo de P\u00e2ncreas da Disciplina de Gastroenterologia Cl\u00ednica do HCFMUSP\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/author\\\/mamarzinotto\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Pancreatite Aguda - Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico? - Gastropedia","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/","og_locale":"pt_BR","og_type":"article","og_title":"Pancreatite Aguda - Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico?","og_description":"Voltamos com mais uma controv\u00e9rsia em pancreatite aguda (voc\u00eas podem ler sobre outras controv\u00e9rsias em Pancreatite Aguda \u2013 Controv\u00e9rsias Parte I: Qual a melhor maneira de predizer a gravidade? e&hellip;","og_url":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/","og_site_name":"Gastropedia","article_published_time":"2025-06-26T09:30:00+00:00","article_modified_time":"2025-06-27T18:05:56+00:00","og_image":[{"width":1259,"height":872,"url":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda.jpeg?v=1749690392","type":"image\/jpeg"}],"author":"Maira Marzinotto","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Maira Marzinotto","Est. tempo de leitura":"6 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/#article","isPartOf":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/"},"author":{"name":"Maira Marzinotto","@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/bc9eb1d348f7591af72ba0facb603c11"},"headline":"Pancreatite Aguda &#8211; Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico?","datePublished":"2025-06-26T09:30:00+00:00","dateModified":"2025-06-27T18:05:56+00:00","mainEntityOfPage":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/"},"wordCount":944,"commentCount":0,"image":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/#primaryimage"},"thumbnailUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda.jpeg?v=1749690392","articleSection":["Gastroenterologia","P\u00e2ncreas"],"inLanguage":"pt-BR","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/","url":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/","name":"Pancreatite Aguda - Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico? - Gastropedia","isPartOf":{"@id":"https:\/\/gastropedia.pub\/pt\/#website"},"primaryImageOfPage":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/#primaryimage"},"image":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/#primaryimage"},"thumbnailUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda.jpeg?v=1749690392","datePublished":"2025-06-26T09:30:00+00:00","dateModified":"2025-06-27T18:05:56+00:00","author":{"@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/bc9eb1d348f7591af72ba0facb603c11"},"breadcrumb":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/#breadcrumb"},"inLanguage":"pt-BR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/"]}]},{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/#primaryimage","url":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda.jpeg?v=1749690392","contentUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2025\/06\/pancreatite-aguda.jpeg?v=1749690392","width":1259,"height":872},{"@type":"BreadcrumbList","@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/pancreatite-aguda-controversias-parte-iii-mas-e-o-antibiotico\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"In\u00edcio","item":"https:\/\/gastropedia.pub\/pt\/"},{"@type":"ListItem","position":2,"name":"Pancreatite Aguda &#8211; Controv\u00e9rsias parte III: Mas e o antibi\u00f3tico?"}]},{"@type":"WebSite","@id":"https:\/\/gastropedia.pub\/pt\/#website","url":"https:\/\/gastropedia.pub\/pt\/","name":"Gastropedia","description":"Atualiza\u00e7\u00e3o m\u00e9dica de forma descomplicada para profissionais que trabalham com sa\u00fade do aparelho digestivo.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/gastropedia.pub\/pt\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-BR"},{"@type":"Person","@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/bc9eb1d348f7591af72ba0facb603c11","name":"Maira Marzinotto","image":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"http:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/RENOVADOmaira.jpg","url":"http:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/RENOVADOmaira.jpg","contentUrl":"http:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/RENOVADOmaira.jpg","caption":"Maira Marzinotto"},"description":"Medica respons\u00e1vel pelo Grupo de P\u00e2ncreas da Disciplina de Gastroenterologia Cl\u00ednica do HCFMUSP","url":"https:\/\/gastropedia.pub\/pt\/author\/mamarzinotto\/"}]}},"_links":{"self":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/10014","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/users\/3341"}],"replies":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/comments?post=10014"}],"version-history":[{"count":7,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/10014\/revisions"}],"predecessor-version":[{"id":10079,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/10014\/revisions\/10079"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/media\/10017"}],"wp:attachment":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/media?parent=10014"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/categories?post=10014"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/tags?post=10014"},{"taxonomy":"ano","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/ano?post=10014"},{"taxonomy":"tipo","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/tipo?post=10014"},{"taxonomy":"volume","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/volume?post=10014"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}