The value of continuous 72-hour peritoneal lavage for peritonitis.

Studies were performed in 120 rabbits to determine whether 72-hour peritoneal lavage is beneficial or harmful in the treatment of peritonitis. Results showed that against a high concentration fecal inoculum (90 percent mortality), peritoneal lavage containing gentamicin and clindamycin reduced mortality to 10 to 20 percent (p less than 0.05). Parenteral antibiotics alone and lavage not containing antibiotics did not decrease mortality. By contrast, against a low fecal inoculum (30 percent mortality), peritoneal lavage containing gentamicin and clindamycin did not alter mortality. However, lavage not containing antibiotics increased mortality to 70 to 80 percent (p less than 0.05). These data demonstrate that continuous peritoneal lavage may be helpful in the treatment of peritonitis provided the lavage solution contains antibiotics and may be harmful if it does not contain antibiotics.

Comparative efficacy of cefotiam versus cephalothin in the therapy of skin and soft tissue infections.

Cefotiam was evaluated by a comparative open-label randomized trial with cephalothin in the therapy of skin and soft tissue infections in 39 patients. The most common organism isolated was Staphylococcus aureus (78%). We established evidence of primary infection with gram-negative bacilli in four patients, three of whom were diabetic. Eight patients had mixed infections or superinfections. No patient was evaluated as a treatment failure; for 10 of 39 patients we were unable to recover an etiological agent but demonstrated a clinical cure. Cefotiam was found to be as effective as cephalothin in the therapy of skin and soft tissue infections.

Physical therapists in burn care. Role and staffing patterns.

The purpose of this study was to identify the role and the staffing patterns of physical therapists in 42 major burn care facilities in the United States. A questionnaire designed by the investigators was used to collect the data. Completed questionnaires were returned from 34 (81%) of the burn care facilities, almost all (91%) of which employed physical therapists. Physical therapy was provided six or seven days a week in 74 percent of the facilities and five days a week in 26 percent of the facilities. The work roles of physical therapists and occupational therapists were compared, and significant differences are reported. The primary treatment provided by the physical therapists was exercise (90%), and the primary treatment by occupational therapists was splinting (96%). The most frequently used methods of contracture control and methods of physical therapy follow-up care are reported, as well as the respondents' perceptions about adequacy of physical therapy coverage and turnover of therapists in burn care.