Br. J. Surg. Vol. 62 (1975)645-646
The effect of noxytiolin in experimental peritonitis D. W . K I N G , J . F. G U R R Y A N D B. N . B R O O K E * SUMMARY
The evidence for the value of noxytiolin (Noxyfiex) in peritonitis is contradictory. In a controlled trial of the effect of noxytiolin in peritonitis in rabbits we have found a significant increase in mortality in the trial group compared with a control group, but no significant difference when a dose equivalent to the recommended human dose is used. The postoperative course is adversely affectedin the animals receiving noxytiolin.
NOXYTIOLIN (Noxyflex, Geistlich) has gained acceptance as a therapeutic agent in peritonitis with little objective evidence of its value. It has a different chemical structure from other antibacterial or antimycotic agents and its mode of action has not been determined. A possible explanation of its action is its chemical similarity with methyl-mustard oil, which has a considerable Gram-positive and Gram-negative antibacterial spectrum due to transaminase inhibition. Another theory is that intact noxytiolin may penetrate the bacterial cell membrane and dissociate intracellularly into methyl-thiourea and formaldehyde. According to Browne and Stoller (1970) intraperitoneal injection of noxytiolin offered significant protection against a lethal Gram-negative peritonitis induced with proteus and coliform organisms in guinea-pigs. They also presented a series of patients with faecal peritonitis with a low mortality rate, thought to be due, in part at least, to an instillation of 2.5-5.0g into the peritoneal cavity at the time of operation. However, Cleaver et al. (1974) were unable to show that lavage with noxytiolin was more beneficial than with Hartmann’s solution in faecal peritonitis in rats. We have performed a controlled trial of the effect of noxytiolin in experimental peritonitis in rabbits.
significant at the 5 per cent level (Fisher’s exact probability test). The 3 deaths in the control group occurred on the second postoperative day, but in the noxytiolin group while 7 died during the second postoperative day, the remaining 3 deaths occurred later, between the eighth and eleventh postoperative days. At autopsy all had diffuse purulent peritonitis; this had become walled off into abscess cavities in those dying after 7 days and in those surviving for 2 weeks. A greater postoperative weight loss was seen in the trial group compared with the controls, and this is significant (P
The effect of noxytiolin in experimental peritonitis D. W . K I N G , J . F. G U R R Y A N D B. N . B R O O K E * SUMMARY
The evidence for the value of noxytiolin (Noxyfiex) in peritonitis is contradictory. In a controlled trial of the effect of noxytiolin in peritonitis in rabbits we have found a significant increase in mortality in the trial group compared with a control group, but no significant difference when a dose equivalent to the recommended human dose is used. The postoperative course is adversely affectedin the animals receiving noxytiolin.
NOXYTIOLIN (Noxyflex, Geistlich) has gained acceptance as a therapeutic agent in peritonitis with little objective evidence of its value. It has a different chemical structure from other antibacterial or antimycotic agents and its mode of action has not been determined. A possible explanation of its action is its chemical similarity with methyl-mustard oil, which has a considerable Gram-positive and Gram-negative antibacterial spectrum due to transaminase inhibition. Another theory is that intact noxytiolin may penetrate the bacterial cell membrane and dissociate intracellularly into methyl-thiourea and formaldehyde. According to Browne and Stoller (1970) intraperitoneal injection of noxytiolin offered significant protection against a lethal Gram-negative peritonitis induced with proteus and coliform organisms in guinea-pigs. They also presented a series of patients with faecal peritonitis with a low mortality rate, thought to be due, in part at least, to an instillation of 2.5-5.0g into the peritoneal cavity at the time of operation. However, Cleaver et al. (1974) were unable to show that lavage with noxytiolin was more beneficial than with Hartmann’s solution in faecal peritonitis in rats. We have performed a controlled trial of the effect of noxytiolin in experimental peritonitis in rabbits.
significant at the 5 per cent level (Fisher’s exact probability test). The 3 deaths in the control group occurred on the second postoperative day, but in the noxytiolin group while 7 died during the second postoperative day, the remaining 3 deaths occurred later, between the eighth and eleventh postoperative days. At autopsy all had diffuse purulent peritonitis; this had become walled off into abscess cavities in those dying after 7 days and in those surviving for 2 weeks. A greater postoperative weight loss was seen in the trial group compared with the controls, and this is significant (P
