Prolonged antibiotic peritoneal lavage in the management of gross generalized peritonitis.

Since there is a high mortality and morbidity with conventional therapy in generalized peritonitis, a treatment regime of prolonged continuous peritoneal lavage (two to 10 days) with the lavage solution containing kanamycin (40 mug/ml) and cephalothin (100 mug/ml) was undertaken in 14 cases of gross, well established, diffuse peritonitis. Antibiotics were also given systemically. In 11 cases, in which the causative lesion was definitively repaired, no intraperitoneal complications developed and convalescence was rapid. Three patients, in whom causative lesion was not definitively repaired at operation, subsequently died. Prolonged antibiotic peritoneal lavage appears to be beneficial for patients with gross and diffuse peritoneal soiling, after the causative lesion has been repaired.