A controlled trial of intraperitoneal cephaloridine administration in peritonitis

From a controlled therapeutic trial extending for more than 2 yr and involving 69 patients with appendicitis and peritonitis a clear-cut statistically significant result emerged. There was a major reduction in the incidence of intraperitoneal abscesses using cephaloridine by the intraperitoneal as opposed to the systemic route. After randomized selection into treatment and control groups, cephaloridine, 25 mg/kg was given by injection every 6 hr for 48 hr to the treatment group by i.p. installation and to the control group by systemic injection. Both groups received initial intraoperative peritoneal lavage with normal saline and also continued systemic injections of cephaloridine on postoperative days 3, 4, and 5. Only one out of 36 patients in the treatment group developed a residual intraperitoneal abscess, as opposed to six abscesses developing in 33 patients in the control group. Technical problems and complications of the method were trivial and have not prevented us from continuing and extending the applications of the method.