Rifamycin Lavage in the Treatment of Experimental Intra-Abdominal Infection

Jallouli, Mohamed; Hakim, Ahmed; Znazen, Abir; Sahnoun, Zouheir; Kallel, Hatem; Zghal, K.; Hammami, Adnène; Mhiri, Riadh

doi:10.1016/j.jss.2008.03.041

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…The results of recent experimental studies and meta-analysis reveal that the use of antibiotic lavage is associated with a more favorable treatment outcome compared to irrigation with normal saline (16, 17). In a more recent study, Clindamycin-Gentamicin combination lavage was shown to be effective at preventing surgical-site infections of cancerous patients who underwent colorectal resection (18).…”

Section: Introductionmentioning

confidence: 99%

Irrigation of Abdomen With Imipenem Solution Decreases Surgical Site Infections in Patients With Perforated Appendicitis: A Randomized Clinical Trial

Hesami¹,

Alipour²,

Nikoupour³

et al. 2014

Iran Red Crescent Med J

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Background:Perforated appendicitis is one of the most common causes of acute abdomen requiring emergent surgery for immediate appendectomy and peritoneal cavity irrigation; however, the efficacy of irrigation with antibiotic solutions is controversial.Objectives:The aim of this study was to assess the efficacy of imipenem solution irrigation on post-operative surgical site infections (SSIs), hospital length of stay, and hospital costs. We hypothesized that there would be lower rate of SSIs, a shorter hospital stay, and lower hospital cost in patients with perforated appendicitis who received peritoneal cavity irrigation with imipenem solution in comparison to their counterparts who received irrigation with normal saline.Patients and Methods:In this randomized single-blind parallel-group clinical trial, we enrolled 90 patients with perforated appendicitis with 12-50 years of age and randomly allocated them into experimental group (n = 45) and control group (n = 45). The control group received peritoneal irrigation with normal saline (0.9%) and experimental group underwent peritoneal irrigation with imipenem solution (1 mg/mL). All surgical procedures were performed in Imam Reza Hospital of Kermanshah University of Medical Sciences. The study primary outcome was surgical site infections (including wound infection and abdominal abscess) and the secondary outcomes were length of hospital stay and hospital cost. Chi-squared and t-tests were used to analyze the study data.Results:Imipenem solution irrigation was associated with significant clinical improvement at one-month follow-up. The experimental group presented with significantly lower rate of SSIs and shorter length of hospital stay. The experimental group had lower rate of SSIs compared to the control group (4.4% vs. 22.2%, respectively) (p= 0.013). The duration of hospital stay was nearly one day longer in control group (5.84 ± 2.58 days) vs. experimental group (4.91 ± 1.29 days) (P = 0.034), and hospital costs were $50 lower in experimental group ($500 ± $292) vs. control group ($450 ± $170) (P = 0.281).Conclusions:The study findings revealed that peritoneal lavage with imipenem solution (1 mg/mL) decreases the rate of post-operative SSIs in patients with perforated appendicitis in comparison to patients irrigated with normal saline alone. These patients also had shorter hospital stay, and lower hospital costs.

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Section: Introductionmentioning

confidence: 99%

Irrigation of Abdomen With Imipenem Solution Decreases Surgical Site Infections in Patients With Perforated Appendicitis: A Randomized Clinical Trial

Hesami¹,

Alipour²,

Nikoupour³

et al. 2014

Iran Red Crescent Med J

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“…This difference may be due to the reason that only secondary peritonitis patients were enrolled in this study. However, in the mentioned studies, surgically uncontrollable peritonitis patients were also included and these patients may have an immune compromised situation, which have led to increased mortality in antibioticless groups in those studies (1,(3)(4)(5)14).…”

Section: Discussionmentioning

confidence: 99%

“…The purpose of surgical intervention includes control of infection, drainage of infectious discharge, excision of all necrotized tissues, extensive peritoneal lavage, and prevention of late complications (5,6).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Peritoneal Lavage with Normal Saline and Normal Saline Plus Antibiotic in Acute Peritonitis Patients

Raeeszadeh¹,

Hosseini²,

Khanmohammadi³

et al. 2017

Trauma Mon

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Background: Peritoneal lavage is a need after laparatomies performed for secondary peritonitis. Some previous studies mentioned the benefit of abdominal lavage with antibiotics, in secondary peritonitis operations. The current study aimed to compare normal saline alone (NS) with normal saline plus gentamicin (NS + G) for abdominal lavage in secondary peritonitis. Methods: In this randomized clinical trial (RCT), patients who were referred to the emergency department, and were candidates for urgent laparotomy were enrolled. After giving informed consent, 80 patients were randomized into 2 groups of peritoneal lavage with (NS) and (NS + G). Descriptive statistics were calculated for the presented data. Chi-square test and Fisher's exact test was used for determining the association between qualitative variables. Comparison between the groups was made using the nonparametric Mann-Whitney test. The Kolmogorov-Smirnov test was used for normality of the data. Results: The mean age of the patients was 41.39 years, and 67.5% were male. There were no significant differences in the demographic data, history of abdominal surgery, diabetes, and the cause of peritonitis. Twenty-one patients needed another surgical intervention. The need for surgical interventions was significantly more in the NS group compared to the NS + G group (17.5% vs. 35%, P = 0.039). There was no significant difference in fever, wound infection, admission time, intravenous antibiotic duration, return to work time, and mortality between the 2 groups. Conclusions: It seems that peritoneal lavage with gentamicin in secondary peritonitis may decrease the need for surgical interventions.

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“…[29] Sortini et al [5] compared the efficacy of peritoneal lavage with chloramphenicol, clindamycin, piperacillin, tobramycin, ceftriaxone and imipenem-cilastatin to saline, with adhesion formation increased in study groups. Jallouli et al [9] used rifamycin for peritoneal lavage in a peritonitis model and demonstrated significantly reduced adhesion formation and higher survival rate. On the other hand, in the study by Rappaport et al, [23] cefazolin and tetracycline irrigation increased peritoneal adhesion formation in the non-septic abdomen.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] However, only rifamisin has been studied in experimental sepsis model. [9] The aim of our study was to test the effectiveness of intraperitoneal application of various antibiotics in an experimental intra-abdominal sepsis model created by cecal ligation and puncture.…”

Section: Sonuçmentioning

confidence: 99%