The current status and influencing factors of prophylactic antibacterial drug use in patients with hypertriglyceridemic acute pancreatitis.

The incidence of hypertriglyceridemic acute pancreatitis (HTG-AP) is increasing, while inappropriate antimicrobial use remains a major concern. This study aimed to evaluate current antimicrobial prescribing patterns in HTG-AP patients and identify factors influencing their use. We retrospectively analyzed the clinical data of 154 hospitalized patients with HTG-AP. According to whether antimicrobial therapy was administered, patients were divided into an antibacterial drug group and a non-antibacterial drug group. Multivariable logistic regression was performed to identify independent predictors of antimicrobial use, and receiver operating characteristic (ROC) curves were constructed to assess predictive performance. Logistic regression analysis revealed that admission to the surgical department (OR = 4.950, 95% CI = 1.180-20.690), treatment at medical institutions in Ulanqab (OR = 13.801, 95% CI = 3.161-61.539) or Xing'an Alliance (OR = 16.280, 95% CI = 3.759-69.858), and elevated white blood cell count (OR = 1.291, 95% CI = 1.061-1.561) were independent risk factors for antimicrobial use. Conversely, a higher lymphocyte ratio was independently associated with lower antibacterial drug use (OR = 0.947, 95% CI = 0.909-0.989). The predictive model incorporating these variables demonstrated good discrimination, with an AUC of 0.886. In conclusion, antimicrobial use in HTG-AP patients remains high, with evidence of inappropriate prescribing. Strengthened antimicrobial stewardship is warranted to promote rational therapy.