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Donald E. Fry, MD; Laura Trachtenberg, MS; Hiram C. Polk, Jr, MD

Arch Surg. 1986;121(3):282-284.

Abstract
• Continuous intraperitoneal administration of antibiotics has been recommended as treatment for peritonitis. The necessity of simultaneous systemic administration of antibiotics remains undefined but usually is performed. Moxalactam kinetics in serum were studied in dogs receiving (1) 15 mg/kg intravenously; (2) 15 mg/kg intraperitoneally; (3) 5 mg/kg hourly with peritoneal lavage; (4) 15 mg/kg intravenously followed by 5 mg/kg hourly intraperitoneally; (5) 15 mg/kg intraperitoneally after 24 hours of peritonitis; and (6) 5 mg/kg hourly by peritoneal lavage after 24 hours of peritonitis. intraperitoneally administered moxalactam resulted in sustained serum levels compared with intravenously administered drugs. Repeated exchanges in lavage fluid resulted in progressively higher serum levels with each exchange. Peritonitis results in statistically higher levels of serum antibiotic concentration when compared with controls. Continuous intraperitoneal lavage with antibiotics would not appear to require concomitant systemic drug therapy.

(Arch Surg 1986;121:282-284)

Author Affiliations
From the Departments of Surgery, University of Louisville School of Medicine (Dr Polk and Ms Trachtenberg) and Case Western Reserve University School of Medicine (Dr Fry), Cleveland; the Price Institute of Surgical Research, Louisville; and the Surgical Service, Veterans Administration Medical Center, Cleveland (Dr Fry).

Footnotes
Accepted for publication Sept 26, 1985.

Read before the Ninth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Tampa, Fla, May 11, 1985.

Reprint requests to Surgical Service (112), VA Medical Center, 10701 East Blvd, Cleveland, OH 44106 (Dr Fry).

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