Pancreatic infection is the leading cause of death from acute pancreatitis. Patients with severe necrotizing pancreatitis are most at risk. Early dynamic computed tomography and percutaneous fine-needle aspiration microbiology of areas of necrosis enable early diagnosis. Several studies has been undertaken in order to investigate the type of bacteria and the concentration reached in pancreatic tissue by different antibiotics. Nevertheless, up to now only three clinical trials of prophylactic antibiotics in acute pancreatitis has been reported. In the IV meeting of the Spanish Association for the Study of the Pancreas, a consensus conference took place with this topic.