Intraperitoneal gentamicin in appendiceal peritonitis in children: a pharmacokinetic study

The present study was conducted in order to document the pharmacokinetic behaviour of Gentamicin when administered intraperitoneally (I.P.) in children with appendiceal peritonitis (15 patients). This pharmacokinetic behaviour was compared to that of intramuscular (I.M.) Gentamicin (12 patients). In both groups, the dose was 2.5 mg/kg/8 hours. In the I.P. group the resulting peak levels were generally low (sub-therapeutic) whilst the peak levels in the I.M. group were, in most cases, satisfactory and similar to those reported by other investigators. In both groups there was wide inter-patient variation in levels. No correlation was found between peak levels and blood Hb., haematocrit or serum urea and creatinine, but it must be noted that in most of the patients, the values of these parameters were within the normal range for their age. It emerged from the study that if Gentamicin is to be given intra-peritoneally, the dosage should be higher than that recommended for the intramuscular or intravenous route and that levels should be monitored because of interpatient variation in response.