A rationale for intraperitoneally administered antibiotic therapy.

A satisfactory clinical response occurred in 96.7 per cent of 210 patients with proved bacterial peritonitis following appropriate surgical intervention and an antimicrobial regimen of 1 per cent cephalothin administered intraperitoneally, with supplementary antibiotics as indicated. Instillation of cephalothin achieves the therapeutic benefits of high intraperitoneal levels with an antibiotic of broad activity and minimum toxicity and permits flexibility in the choice of additional antimicrobial therapy. Adjuvant therapy with cephalothin did not result in peritoneal adhesions or significant abdominal pain. Clinical experience suggests that it may promote healing of anastomotic leaks. The results of this study indicate that intraperitoneally administered cephalothin is a significant factor in lowering the death rate in peritonitis.