Haffner J F, Eng J, Lotveit T, Aune S
Ann Chir Gynaecol Suppl. 1976;65(1):22-6.
Peritoneal lavage with ten hourly repeated instillation-drainages of one litre lavage fluid containing 50 mg doxycycline (Vibramycin Pfizer) was carried out on six patients suffering from diffuse peritonitis due to perforated appendicitis. Bacteriological specimens were obtained both from the perforation in the appendix and the peritoneal fluid at operation and the doxycycline concentrations in blood and lavage fluid were determined at intervals up to 72 hours postoperatively. All the patients recovered, but the lavage was considered a failure in one case as a small abscess and multiple adhesions were found at reoperation 1 1/2 months later. Bacteriological swabs from the perforated appendix and the peritoneal fluid usually contained the same bacteriological species, and as a rule several species were isolated. Doxycycline compared favourably with ampicillin as regards bacterial sensitivity, but the difference was too slight to be of practical importance. Doxycycline was absorbed very rapidly from the peritoneal cavitiy, and due to its slow excretion a cumulation occurred. In this small series doxycycline did not appear to give any real advantage over ampicillin, but it may be considered the drug of choice in patients with penicillin allergy, and in those who fail to respond to ampicillin.
对6例因阑尾穿孔导致弥漫性腹膜炎的患者进行了腹腔灌洗，每10小时重复进行1升含50毫克强力霉素（辉瑞公司的维霸霉素）灌洗液的滴注-引流操作。术中从阑尾穿孔处和腹腔液中获取细菌学标本，并在术后72小时内定期测定血液和灌洗液中的强力霉素浓度。所有患者均康复，但有1例患者被认为灌洗失败，因为在1个半月后再次手术时发现了一个小脓肿和多处粘连。来自穿孔阑尾和腹腔液的细菌学拭子通常含有相同的细菌种类，而且通常能分离出几种细菌。在细菌敏感性方面，强力霉素与氨苄西林相比有优势，但差异太小，无实际意义。强力霉素从腹腔吸收非常迅速，由于其排泄缓慢，会发生蓄积。在这个小系列研究中，强力霉素似乎没有比氨苄西林有任何真正的优势，但对于青霉素过敏的患者以及对氨苄西林无反应的患者，它可被视为首选药物。
