[Experimental study of a new method of endolymphatic antibiotic administration and a trial of its clinical use]

A new procedure for antibiotic administration via endolymphatic route was developed. Experiments performed on 34 dogs revealed differences in the pharmacokinetics of gentamicin in the central lymph after its administration in a dose of 4 mg/kg via endolymphatic and intramuscular routes: the maximum levels of 590 and 23 mg/kg were determined in 15 and 45 minutes respectively. In 1 hour the concentrations decreased to 17 and 10 mg/kg. When gentamicin was administered endolymphatically it remained in the lymph and blood in concentrations of 0.2 and 0.8 mg/kg respectively for 24 hours. The kinetics of gentamicin in the blood serum within the first 6 hours after its administration by both routes did not differ significantly. After endolymphatic administration high concentrations of gentamicin (56-36 mg/g) were determined in the paraaortal and retroperitoneal lymph nodes in 10-24 hours. Within the period of the 4th to the 13th day its concentrations of at least 5 mg/g were detected. The changes in the structure of the lymph nodes observed 18-48 hours after the antibiotic endolymphatic administration were reversible and returned to normal by the 96th hour. The first experience with the clinical use of the endolymphatic route of gentamicin administration showed its high efficacy in 84.8% of the patients with severe purulent inflammatory diseases of the organs of the abdominal cavity. The antibiotic was used in a dose of 80 mg once a day. The treatment course consisted of 5-6 infusions. Perspectives of the further experimental and clinical investigation of the procedure are indicated. Endolymphatic administration of antibiotics makes it possible to increase the efficacy of antibiotic therapy of a number of severe inflammatory infections.