The biology of peritonitis and implications for treatment.

Peritonitis continues to be one of the major infectious problems confronting surgeons. Despite the many advances in antimicrobial agents and supportive care, mortality from diffuse suppurative peritonitis remains unacceptably high. The authors review the anatomy and defense capabilities of the peritoneal cavity and then focus on the polymicrobial nature of peritonitis and how, through microbial interactions with host defenses, there is either resolution or persistent infection. They also consider possible infection-potentiating agents in the peritoneal cavity and experimental modes of therapy.