The Effect of Peritoneal Prednisolone Lavage in Bacterial Peritonitis: An Experimental Study

This study investigated and compared the effects of antibiotic and steroid lavage on survival and cytokine levels in an experimental abdominal sepsis model.

In abdominal sepsis, abdominal lavage with saline or antibiotic solutions is a well-documented intervention known to have positive impact on survival; however, the effects of steroid lavage in abdominal sepsis have not yet been investigated.

Ninety-six Wistar rats were divided into 4 groups (n = 24). Abdominal sepsis was induced by cecal ligation and puncture. Six hours after laparotomy, the authors performed a relaparatomy followed by cecal resection and an abdominal lavage. Abdominal lavage was performed using saline in group 1, equal volumes of cefazolin sodium in group 2, low-dose methylprednisolone (1 mg/kg) in group 3, and high-dose methylprednisolone (2 mg/kg) in group 4. After division of 2 subgroups from each of the 4 groups, the first of the rats (n = 12) were euthanized 6 hours later for evaluation of cytokines (ie, interleukin [IL] 1β, 2, 4, 10, and tumor necrosis factor alpha [TNF-α]), and the others were followed for 30 days for analysis of mortality rates.

The mortality rate of the rats in group 2 was significantly higher than group 4, which had no mortality (P = 0.032). Although insignificant, the lowest mean value of IL-1β, IL-2, and TNF-α were in group 1, and the highest was in group 2. The lowest IL-4 level was in group 3, and the highest level was in group 2 (P = 0.41). Interleukin-10 levels were significantly lower in group 4 and higher in group 2 (P = 0.014).

The authors state that peritoneal lavage with prednisolone improved survival rates with increasing doses in abdominal sepsis.