THE FUNDAMENTAL principles of treatment of acute secondary peritonitis consist of immediate extirpation of the focus of infection whenever possible and "walling off" of the infectious process by host defenses. The use of potent antimicrobial agents in the regimen of supportive therapy has tipped the balance of forces in favor of the defense mechanisms by providing means for direct attack on the offending bacteria.
Sulfonamides, the first of the modern antimicrobial drugs, were shown to influence favorably early spreading but not localizing or localized peritonitis of fecal origin.1 Penicillin, initially considered without influence on severe mixed infections, was demonstrated to be effective in peritonitis in the experimental animal and in patients when used in large doses.2 Streptomycin also was shown to influence the outcome of human peritonitis.3 Danger of untoward effects peculiar to earlier preparations and the threat of persisting infection with drug-resistant organisms restrained acceptance of
ERIC , PULASKI EJ, ARTZ CP, SHAEFFER JR. TERRAMYCIN IN TREATMENT OF PERITONITIS. AMA Arch Surg. 1952;64(1):5-9. doi:10.1001/archsurg.1952.01260010016002