Randomised trial of intraperitoneal irrigation with low molecular weight povidone-iodine solution to reduce intra-abdominal infectious complications.

A prospective randomized trial was performed comparing the efficacy of intraperitoneal irrigation with low molecular weight povidone-iodine solution ('Betadine LMW') (PVP-I LMW) in reducing the risk of intra-abdominal infectious complications. Seventy-five patients who were undergoing surgical procedures in the face of bacterial contamination were studied. Patients were intra-operatively randomized to receive intraperitoneal irrigation prior to abdominal closure with PVP-I LMW or with saline. Patients were maintained on peri-operative systemic antibiotics, and surgical incisions were drained and were closed primarily or left open according to the practice of the surgeon responsible. If incisions were closed, the subcutaneous tissue was irrigated prior to skin closure with the same irrigant as used intraperitoneally, PVP-I LMW or saline. Patients were followed for abnormal wound healing, peritonitis, intra-abdominal abscesses, or other infectious complications. Serum iodine levels were monitored in some patients. Intra-abdominal infectious complications developed in two of 37 patients receiving PVP-I LMW irrigation as compared to complications in nine of 38 patients receiving saline irrigation (P less than 0.05). When infectious complications were excluded that were possibly due to surgical technical failures (such as anastomotic leakage), peritonitis or intra-abdominal abscesses were observed in one of 37 PVP-I LMW patients and in seven of 38 saline control patients (P less than 0.05). Wound infections developed in one of 37 PVP-I LMW patients and in three of 38 control patients. A broad range of serum iodine levels were observed in control patients preoperatively and at 24 h and 7 days postoperatively. Serum iodine levels in 'Betadine LMW' patients rose approximately nine-fold by 24 h postoperatively and returned to pre-operative levels by 7 days. It was concluded that PVP-I LMW solution can reduce the incidence of intra-abdominal infectious complications when used as an intraperitoneal irrigant in patients undergoing bacterially-contaminated surgical procedures.

Anti-inflammatory and other pharmacodynamic properties of five members of the 4-aryl-1-isopropyl-2(1H)-quinazolinone series.

A series of five 4-aryl-1-isopropyl-2(1H)-quinazolinone analogs were examined for their relative activities regarding analgesia, suppression of inflammation and pyresis, and associated phenomena. Two of these, proquazone (SaH 43-715, Biarsan, Biarison) and fluproquazone (SaH 46-790), are clinically effective anti-inflammatory and analgesic agents. Acetylsalicylic acid (ASA) and phenylbutazone were included for reference as first and second generation nonsteroidal anti-inflammatory drugs (NSAID), respectively. In general, substitutions in these five quinazolinone analogs produced noticeable changes in potency in several activities but changes of lesser degrees in others. Compared to ASA and phenylbutazone the quinazolinones exhibited better analgesic and related activities.

The anti-inflammatory profile of proquazone.

Proquazone, 1-isopropyl-4-phenyl-7-methyl-2(1H)-quinazolinone is an orally effective anti-inflammatory analgesic and antipyretic compound in animal models. The compound is less ulcerogenic than indomethacin in the rat and appears to potentiate the anti-inflammatory and thymus involution effects of hydrocortisone in this species. That a nonacidic nonsteroidal compound would display a spectrum of anti-inflammatory activity similar to that previously found only with acidic compounds will be the subject of further investigations.