Cefotiam dihydrochloride (CTM) in a dose of 2 g was given by intravenous bolus injection to 15 patients operated upon for acute or subacute abdominal organs. They were included to 5 cases of acute localized peritonitis due to perforative appendicitis, 3 of diffuse peritonitis due to perforative duodenal ulcer, 1 of diffuse peritonitis with intestinal obstruction, 1 of perforative sigmoid colon cancer, 2 of gastric cancer or polyp with cholelithiasis, and 3 of cholangitis with cholecyst-choledocholithiasis. The materials of exudate from drain were taken at intervals by sterilized paper disc and determined by paper disc bioassay method with Proteus rettgeri ATCC 9250 or Proteus mirabilis ATCC 21100 as the test organisms to CTM concentrations. CTM concentrations in purulent exudate from drain of patients with acute peritonitis, they were increased quickly after intravenous bolus injection, and reached higher levels at early time after injection in cases 2 or 3 days after operation. CTM concentration in purulent exudate from drain was tended to increase in proportion to the severity of the inflammation. The CTM levels in infected exudate were higher than the MICs against clinically isolated organisms for a long time after administration. Therefore, CTM was very useful drug when used for chemotherapy of postoperative peritonitis.

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