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Antiseptics in the treatment of bacterial peritonitis in rats
Abstract:
A controlled mixed peritoneal infection was produced by inoculation of bacteria into the peritoneum and peritonitis was allowed to become established. A laparotomy was performed and peritoneal toilet with a variety of agents was carried out. Local povidone-iodine in the inflamed peritoneum proved to be not only of no benefit but, in fact, to be toxic. In the standard concentrations recommended it proved lethal. Noxythiolin 2.5 per cent also had no beneficial effect. There was a significant difference between the effect of povidone-iodine when instilled into an inflamed peritoneum and instillation into the intact peritoneal cavity. We would advise caution in the use of these antiseptics in any situation in which local defence mechanisms have been compromised as a result of established infection.
Insights
Povidone-iodine and noxythiolin antiseptics showed no benefit and potential toxicity when used for peritoneal toilet in established peritonitis. Caution is advised when using these agents in compromised abdominal infections.
Area of Science:
- Surgical Research
- Infectious Diseases
- Antiseptic Efficacy
Background:
- Peritonitis is a serious abdominal infection requiring prompt treatment.
- Peritoneal toilet is a common surgical procedure to manage peritonitis.
- The efficacy and safety of antiseptics in established peritonitis are not fully understood.
Purpose of the Study:
- To evaluate the effectiveness of local antiseptics in managing established peritonitis.
- To compare the effects of povidone-iodine in inflamed versus intact peritoneal cavities.
- To assess the potential toxicity of commonly used antiseptics during peritoneal lavage.
Main Methods:
- A controlled mixed bacterial peritonitis model was established in animals.
- Peritoneal toilet was performed using various antiseptic agents.
- The effects of povidone-iodine and noxythiolin were specifically investigated.
- Comparisons were made between inflamed and intact peritoneal instillations.
Main Results:
- Local povidone-iodine was not beneficial and proved toxic, even lethal, in established peritonitis.
- Noxythiolin 2.5% demonstrated no beneficial effect.
- Povidone-iodine showed a significant difference in effect between inflamed and intact peritoneum.
Conclusions:
- Standard concentrations of povidone-iodine and noxythiolin are not recommended for peritoneal toilet in established peritonitis.
- Caution is advised when using these antiseptics in compromised abdominal infections.
- Further research is needed to identify safe and effective agents for peritoneal lavage.