EFFECT OF INTRAPERITONEAL ANTIMICROBIALS ON THE CONCENTRATION OF BACTERIA, ENDOTOXIN, AND TUMOR-NECROSIS-FACTOR IN ABDOMINAL FLUID AND PLASMA IN RATS

The efficacy of intraperitoneal instillation of antimicrobial agents i n eliminating the bacterial contaminant in patients with generalized p eritonitis remains controversial. We determined the effect of intraper itoneal instillation of taurolidine or imipenem on mortality, and on t he concentration of bacteria, endotoxin, and tumor necrosis factor (TN F) in rats with intraperitoneally injected bacteria. Thirty rats were inoculated intraperitoneally with two enteric bacterial strains, follo wed by either taurolidine, saline, or imipenem, Abdominal fluid and bl ood were analyzed at different time intervals. The survival rate was h ighest in the imipenem group (p < 0.05). The bacterial concentration i n abdominal fluid in the taurolidine and imipenem group was lower than in the saline group (p < 0.005), but the concentration in the imipene m group was lowest (p < 0.005). The endotoxin concentration in abdomin al fluid and plasma in the taurolidine group was lower than in the oth er two groups (p < 0.05). The TNF concentration in abdominal fluid and plasma in the taurolidine group was lower than in the saline group (p < 0.05), whereas the concentration in the imipenem group was higher ( p < 0.005). We conclude that topically applied taurolidine in rats wit h intraperitoneally injected bacteria may have a weak antibacterial ef fect, and lowered concentrations of endotoxin and TNF. Topically appli ed imipenem had a profound bactericidal activity but induced endotoxin and TNF release.