[Biliary excretion of cefotaxime and desacetylcefotaxime].
The biliary excretion of cefotaxime (CTX) and its metabolite desacetylcefotaxime (DSCTX) was measured by HPLC in 9 recently cholecystectomized-patients following the IV injection of 15 mg/kg body weight of CTX. The totality of bile was collected by an original procedure: the inflated balloon of a Fogarty catheter was introduced into the distal branch of a Kehr drain T-tube. Biliary clearance of CTX and DSCTX was measured for 8 h. Cefotaxime peaked at 90 min. after injection at 34.5 +/- 15.3 micrograms/ml; in the 7-8 h sample it was 2.7 +/- 1.7 micrograms/ml. DSCTX peaked at the same time at 49.3 +/- 17.0 micrograms/ml, and was 4.6 +/- 3.2 micrograms/ml at 8 h. The bile/serum ratio of CTX and DSCTX concentration was 1 from the 1st to the 8th hours (range: 1.35 +/- 1.08 to 11.0 +/- 3.1). The biliary clearance of CTX was 0.190 ml/min. The total amounts of CTX and DSCTX eliminated in bile were respectively 1050 +/- 472.8 micrograms and 1902.7 +/- 804.1 micrograms (0.093 +/- 0.041 p. 100 of the dose and 0.186 +/- 0.077 p. 100 of the dose). Considering the minimum inhibitory concentration of the pathogens currently encountered in the biliary sepsis, CTX should be a suitable antimicrobial agent for the treatment of biliary infections.
Jehl
F
F
Institut de bactériologie, Centre hospitalo-universitaire, Strasbourg.
Peter
J D
JD
Picard
A
A
Dupeyron
J P
JP
Marescaux
J
J
Sibilly
A
A
Monteil
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000378:metabolism*; D001649:Bile Duct Diseases / Q000601:surgery; D002439:Cefotaxime / Q000031:analogs & derivatives / Q000378:metabolism*; D002769:Cholelithiasis / Q000601:surgery; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D008875:Middle Aged; D011184:Postoperative Period
C029281:desacetylcefotaxime; D002439:Cefotaxime
Elimination biliaire du céfotaxime et du désacétylcéfotaxime.