Excretion of cefamandole, cefazolin, and cephalothin into T-tube bile.
The biliary tract excretion of cefamandole, cefazolin, and cephalothin was measured in eight patients with T-tubes inserted into their common ducts after ductal exploration for biliary tract stones. Each patient received 1.0 g intravenously of each cephalosporin on 3 separate days; T-tube bile and serum were collected at selected time intervals thereafter. In seven patients, bile and urine were collected for 6 h after the administration of each drug. Mean peak levels of cefamandole, cefazolin, and cephalothin in bile were 352, 46, and 12 mug/ml, respectively. The respective mean peak serum levels were 55.0, 92.8, and 32.4 mug/ml. Despite the fact that peak serum levels of cefazolin were 1.5 times those of cefamandole, levels in bile of cefamandole were about 8 times those of cefazolin. Over a 6-h period, almost three times as much cefamandole was excreted into bile as was cefazolin. Therefore, in those patients with biliary tract sepsis, in whom a cephalosporin is indicated for therapy, cefamandole appears to be the drug of choice.
D000328:Adult; D000368:Aged; D001646:Bile / Q000378:metabolism*; D002435:Cefamandole / Q000097:blood / Q000378:metabolism; D002437:Cefazolin / Q000097:blood / Q000378:metabolism; D002511:Cephalosporins / Q000378:metabolism*; D002512:Cephalothin / Q000097:blood / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D013997:Time Factors
D002511:Cephalosporins; D002435:Cefamandole; D002437:Cefazolin; D002512:Cephalothin