Intraperitoneal povidone-iodine in experimental peritonitis.

Two experimental models were utilized to study the efficacy of intraperitoneal povidone-iodine in an established peritonitis. In both models, there was a 100% mortality in the povidone-iodine treated group. In laboratories which have reported favorable results, the animals were treated before peritonitis was allowed to develop. Clinical studies with povidone-iodine lavage have used dilute solutions which did not remain in the infected space. The effectiveness of this method was probably due to mechanical continuous irrigation. Our toxicity studies showed povidone-iodine to be fatal in normal animals in dosages exceeding 4.0 ml/kg. However, a dose of 2.0 ml/kg, which was nontoxic in normal animals, was fatal in animals with peritonitis. This study strongly suggests that the intraperitoneal administration of povidone-iodine can be fatal when the animal is compromised by peritonitis. The mechanism of this effect is unclear. On the basis of these studies, the intraperitoneal administration of povidone-iodine cannot be recommended for therapy of peritonitis.