Pentoxifylline as an adjuvant to surgery and antibiotics in the treatment of perforation peritonitis: a prospective, randomised placebo-controlled study

Sireesh I, Kaman L, Singh R
Correspondence: Dr Lileswar Kaman, kamanlil@yahoo.com

ABSTRACT
Introduction In animal models and human trials, pentoxifylline has shown beneficial pharmacological effects in the treatment of septic shock. We evaluated the role of pentoxifylline in the treatment of perforation peritonitis, as an adjuvant to surgery and standard antibiotic treatment.
Methods A prospective, randomised placebo-controlled trial was conducted on 50 patients with perforation peritonitis. 25 patients were randomised to the test group and 25 patients to the control group. In addition to standard treatment, the test group of patients received pentoxifylline 200 mg per day as an adjuvant for three days. The endpoints of the study were to evaluate the condition of the wound in the postoperative period, APACHE II score and total duration of hospital stay.
Results Both groups were comparable in all aspects. There were 23 male and two female patients in the test group, and 20 male and five female patients in the control group (p-value is 0.021). Mean age was 37.9 +/- 10.5 years in the test group and 33.8 +/- 11.0 years in the control group (p-value is 0.186). The APACHE II score in the test group and in the control group was statistically not significant (p-value is 0.661). In the test group, seven (28 percent) patients had wound infection and in the control group, 13 (52 percent) patients had wound infection (p-value is 0.083). The mean postoperative hospital stay in the test group was 6.8 +/- 2.1 days and in the control group, it was 11.2 +/- 5.2 days (p-value is 0.001).
Conclusion Pentoxifylline improved the outcome by significantly decreasing the length of the hospital stay and the rate of wound infection.

Keywords: pentoxifylline, perforation peritonitis, septic shock, surgical complications, wound infection
Singapore Med J 2008; 49(8): 619-23