The article is based on an analysis of results of complex treatment of 497 patients with pancreatonecrosis at the period from 2010 to 2014. All patients were admitted to the surgical departments of Republican hospital № 2 and Centre of Emergency Medicine of Republic of Sakha (Yakutia). The investigation allowed adaptation and development of antibiotic prophylaxis and therapy management in pancreatonecrosis in multifield surgical hospital. More than 80% of patients avoided a contamination of necrotic destruction zones. The level of lethality was reduced in group of patients with infectious complications of pancreatonecrosis from 45,8% to 37,7%.