[Excretion of antibiotics into bile and urine in patients with external cholecystostomy done in order to treat obstructive jaundice].
Biliary and urinary concentrations and recoveries of 3 different antibiotics (piperacillin (PIPC), cefbuperazone (CBPZ) and cefoperazone (CPZ], after intravenous bolus injection were studied using the crossover method with external cholecystostomies done in order to treat obstructive jaundice due to complete obstruction of the lower biliary tract; the concentrations of antibiotics in bile and urine were determined by means of a high performance liquid chromatography method. Drug concentrations and recoveries in the bile after intravenous injection of these antibiotics were at levels in the order of CPZ greater than CBPZ greater than PIPC. Since our patients were inflicted with various malignancies which made them impaired in terms of biliary excretion of antibiotics, the concentrations of those drugs in the bile were lower than those previously reported by several investigators. However, CBPZ and CPZ showed sufficient levels of excretion into the bile and their amounts were high enough when compared to the value of MIC 80% reported recently against Escherichia coli and Klebsiella pneumoniae, which are known to be main pathogens of biliary system infections. The excretion of CPZ into the bile was invariably found to be 2 times or more as high as the other 2 drugs tested. Concentrations and recoveries of the 3 antibiotics excreted into urine were similar to the cefotaxime excretion, of which into urine had been reported to be excellent. Thus, CBPZ and CPZ appeared to be effective against biliary system infections, even with blockage of antibiotics excretion into the bile.
Hidaka
K
K
Department of Surgery, Saga Medical School.
Yamamoto
H
H
Harada
S
S
Katano
M
M
Fujiwara
H
H
Mizoguchi
T
T
Hisatsugu
T
T
Yamaoka
K
K
Kisu
T
T
D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000378:metabolism*; D002438:Cefoperazone / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000652:urine; D002513:Cephamycins / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000652:urine; D002767:Cholecystostomy; D002779:Cholestasis / Q000378:metabolism* / Q000601:surgery; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D010878:Piperacillin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000652:urine; D013997:Time Factors
D002513:Cephamycins; D002438:Cefoperazone; C035978:cefbuperazone; D010878:Piperacillin