Plasma and peritoneal fluid concentrations of ceftriaxone after intravenous and intraperitoneal administration in horses.
Authors: Alonso J M, Peccinini R G, Campos M L, Nitta T Y, Akutagawa T Y M, Crescencio A P, Alves A L G, Rodrigues C A, Watanabe M J, Hussni C A
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: Ceftriaxone Administration Routes in Equine Peritonitis When treating peritonitis in horses, achieving adequate antimicrobial concentrations within the peritoneal cavity presents a significant clinical challenge, making direct intraperitoneal (IP) delivery an attractive alternative to intravenous (IV) administration. Researchers compared plasma and peritoneal fluid ceftriaxone levels across two groups of five horses: one receiving 25 mg/kg IP once daily for five days, and another receiving the same IV dose plus concurrent IP saline flushes. Intraperitoneal administration substantially outperformed IV delivery, maintaining ceftriaxone concentrations above the minimum inhibitory concentration (MIC) of 1 μg/mL for 24 hours in peritoneal fluid versus only 12 hours with IV dosing, whilst plasma levels remained therapeutically elevated for 12 hours IP compared to 10 hours IV. No adverse effects were documented with either route across the five-day treatment period. For practitioners managing horses with peritonitis, these findings suggest IP ceftriaxone (25 mg/kg in 1 litre saline solution, once daily) offers superior peritoneal drug penetration and prolonged therapeutic coverage, potentially improving clinical outcomes in septic peritoneal disease where maintaining local antimicrobial efficacy is paramount.
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Practical Takeaways
- •For horses requiring peritonitis treatment, intraperitoneal ceftriaxone administration delivers higher drug concentrations directly to the infection site for longer duration than IV administration, potentially improving clinical outcomes
- •The IP route is safe with no adverse effects observed, making it a viable alternative to IV administration when treating peritoneal infections
- •Consider intraperitoneal ceftriaxone dosing at 25 mg/kg diluted in 1L saline solution once daily for equine peritonitis prophylaxis and treatment protocols
Key Findings
- •Intraperitoneal ceftriaxone administration achieved therapeutic concentrations (>1 μg/mL MIC) in peritoneal fluid for 24 hours versus only 12 hours with intravenous administration
- •Intraperitoneal administration provided greater cephalosporin availability in peritoneal fluid with higher peak concentrations and longer duration above MIC compared to intravenous route
- •No adverse effects were observed with either administration route over the 5-day treatment period
- •Intraperitoneal ceftriaxone (25 mg/kg in 1L saline daily) may be useful for prophylaxis and treatment of equine peritonitis