Treatment of acute peritonitis with aureomycin

Abstract

1. 1. This is a preliminary report of the use of aureomycin in the treatment of fifty-two unselected patients with acute peritonitis due to appendicitis, perforated gastroduodenal ulcers and one perforated diverticulum. 2. 2. There has been a definite reduction of mortality in this small series when compared with our hospital mortality for the previous two years. All deaths occurred prior to the introduction of the intravenous-oral therapeutic regimen. 3. 3. The bacteriologic findings were inconclusive when correlated with clinical course. A mixed flora was the common finding in appendical peritonitis while a pure culture was the usual finding in perforated ulcers. 4. 4. The combination of initial intravenous dosage followed, as soon as feasible, by oral administration of the drug has proven clinically to be the most successful procedure. Five hundred mg. of the drug with 500 cc. of 5 per cent glucose in water as the vehicle was given by infusion twice daily. As soon as Wangensteen suction could be safely interrupted, oral dosage of 500 mg. twice daily was begun and usually continued for an average of seven to ten days. 5. 5. Minimal toxic reactions were noted. The drug produced a chemical phlebitis in some patients but did not prolong the course of the disease. 6. 6. Aureomycin has proven to be of significant value in the therapy of peritonitis. Our series is too small to define the precise role of the antibiotic in this grave infection but results are impressive enough to warrant further extensive clinical investigation of the drug. 7. 7. This work is still in progress and a detailed report will be published at a later date.