Local treatment of generalised peritonitis in rats; effects on bacteria, endotoxin and mortality.
OBJECTIVE
To assess the effect of debridement, intraoperative lavage with saline, and additional instillation of taurolidine or imipenem/cilastatin in rats with faecal peritonitis.


METHODS
Laboratory study.


METHODS
University hospital, The Netherlands.


METHODS
60 male Wistar rats.


METHODS
Rats were given an intraperitoneal injection of a faecal suspension containing Escherichia coli and Bacteroides fragilis. Six groups of 10: sham operation, debridement, debridement with saline lavage, debridement with saline lavage with intraperitoneal instillation of saline or taurolidine, or imipenem/cilastatin, were studied.


METHODS
Bacterial growth and endotoxin concentration in abdominal exudate and plasma, abscess formation, and mortality.


RESULTS
Debridement temporarily reduced bacterial growth and the concentration of endotoxin in abdominal exudate, and delayed mortality. Lavage with saline further reduced bacterial growth and the endotoxin concentration. It also reduced the plasma endotoxin concentration, and mortality. Additional instillation of taurolidine did not reduce bacterial growth, but did initially reduce the endotoxin concentration in abdominal exudate and plasma. Instillation of imipenem/cilastatin, after debridement and lavage, significantly reduced all variables measured.


CONCLUSIONS
In rats with faecal peritonitis, debridement, lavage with saline, and additional instillation of imipenem/cilastatin, all have cumulatively reducing effect on bacterial growth, endotoxin concentrations, abscess formation, and mortality. Instillation of taurolidine reduces only the amount of endotoxin.
Rosman
C
C
Department of Surgery, University Hospital, Groningen, The Netherlands.
Westerveld
G J
GJ
Kooi
K
K
Bleichrodt
R P
RP
D018784:Abdominal Abscess / Q000209:etiology / Q000517:prevention & control; D000818:Animals; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D015377:Cilastatin / Q000627:therapeutic use; D003646:Debridement; D004338:Drug Combinations; D004731:Endotoxins / Q000032:analysis; D015378:Imipenem / Q000627:therapeutic use; D007322:Instillation, Drug; D008297:Male; D010538:Peritonitis / Q000150:complications / Q000382:microbiology / Q000628:therapy*; D011480:Protease Inhibitors / Q000627:therapeutic use; D051381:Rats; D017208:Rats, Wistar; D013654:Taurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D007507:Therapeutic Irrigation; D013829:Thiadiazines / Q000627:therapeutic use; D013845:Thienamycins / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; D004731:Endotoxins; D011480:Protease Inhibitors; D013829:Thiadiazines; D013845:Thienamycins; D015377:Cilastatin; D013654:Taurine; D015378:Imipenem; C012566:taurolidine