Continuous Antibiotic Irrigation in the Treatment of Infection

Abstract

Certain experimental and clinical observations indicate that the local use of antibiotics may be more effective in some situations than their systemic administration. Poth, for example, showed that when neomycin was added to a 10% suspension of human feces no bacteria could be cultured.¹ Furthermore, if mice were inoculated intraperitoneally with 1 cc. of 10% human feces none survived, while in contrast, all survived if neomycin were given intraperitoneally within 1 hour of the fecal injection. Poth also demonstrated that the instillation of neomycin solution is effective in sterilizing the human intestinal tract within 30 minutes. Sterilization of peritoneal fluid has also been noted following intraperitoneal instillation of antibiotics in patients with acute bacterial peritonitis secondary to perforation of the gastrointestinal tract.² Because of these considerations antibiotics have been used intraperitoneally by us and our associates for several years in patients with peritoneal contamination and in patients undergoing