Gentamicin intraperitoneal

The in vivo protective activity of rifaximin was studied in mice, infected experimentally by intraperitoneal inoculation of S. aureus Colliva and compared to that of rifampicin (a systemic rifamycin) and gentamicin (a poorly absorbed aminoglycoside) [74]. After oral administration, only rifampicin was effective whereas the other two compounds were inactive at doses up to 10 mg/kg. However, when injected subcutaneously, rifaximin displayed a good therapeutic efficacy (table 2). While confirming its antibacterial activity, these results clearly indicate that rifaximin, like gentamycin, is poorly absorbed after oral administration. 

Bolus intraperitoneal gentamicin or tobramycin (5 mg/kg ideal body weight) is safe, achieves therapeutic blood concentrations for extended intervals, causes no clinical ototoxicity or vestibular toxicity, is cost-effective, and is convenient for patients and nurses (170). 

In 18 patients receiving empirical therapy for CAPD-related peritonitis, once-daily intraperitoneal gentamicin (0.6 mg/kg) had less therapeutic benefit and peak serum gentamicin concentrations were lower than the suggested value of 4 pg/ml, whereas trough serum gentamicin... 

Tosukhowong T, Eiam-Ong S, Thamutok K, Wittayalertpanya S, Na Ayudhya DP. Pharmacokinetics of intraperitoneal cefazolin and gentamicin in empiric therapy of peritonitis in continuous ambulatory peritoneal dialysis patients. Peril Dial Int 2001 21(6) 587-94. 

Mineral balance A 45-year-old woman developed symptomatic hj ocalcemia, with metabolic alkalosis, hj okalemia, and hypomagnesemia Bartter-like syndrome), several days after a 10-day course of gentamicin for a urinary tract infection [15 ]. Comorbidities included ovarian cancer treated with intraperitoneal dsplatin (in a dose not thought to cause renal tubular dysfunction). Recovery took 6 weeks, and sustained high-dose electrolyte replacement was required to counteract persistent urinary potassium and calcium losses. The authors suggested that a polyvalent toxin of gentamicin had caused multiple renal tubular abnormalities. 

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