THE TOPICAL USE of streptomycin in peritonitis should have a definite place in surgery either alone or in combination with supporting antibacterial agents. The exact limits of this place have not as yet been determined, and this communication, which is a preliminary report, is an attempt at definition.
The systemic administration of streptomycin in doses of 3 or 4 Gm. daily achieves blood concentrations of 20 to 25 units per cubic centimeter of serum. 1The amount of the drug tolerated by the various species of gram-negative rods found in the intestine varies widely but may be as much as 250 units per cubic centimeter or more. The concentration of streptomycin in the peritoneal cavity of necessity is always less than that in the blood, and in cases of long-standing disease in which there is an impermeable abscess wall systemic administration per se is likely to be totally inadequate.
We therefore decided to investigate the topical use of