title: The effect of biliary decompression on antibiotic biliary excretion.
abstract: OBJECTIVE
  Raised biliary pressure may affect antibiotic biliary excretion. We evaluated whether biliary decompression for patients with biliary obstruction could improve antibiotic biliary excretion.
  
  
  METHODS
  Eight patients with common bile duct obstruction undergoing endoscopic nasobiliary drainage were evaluated. During endoscopic cannulation, biliary pressure above the obstruction and antibiotic concentrations in the bile and peripheral blood were determined 60 min after the intravenous antibiotic (panipenem) administration.
  
  
  RESULTS
  Biliary pressure was initially elevated above normal in all the patients, but normalized after biliary drainage for 5 to 7 days. At the initial endoscopic retrograde cholangiopancreatography, the aspirated bile contained low or undetectable levels of the antibiotic, but the mean bile panipenem concentration and the mean bile/plasma ratio of panipenem concentrations significantly improved after biliary decompression.
  
  
  CONCLUSIONS
  The results suggest an important role of biliary pressure in determining antibiotic transfer into the bile.
authors: Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8506, Japan.
authors: Shin
authors: S
authors: Yamamoto
authors: Yoshitsugu
authors: Y
authors: Kubota
authors: Makoto
authors: M
authors: Takaoka
authors: Mami
authors: M
authors: Ogura
authors: Kazuyuki
authors: K
authors: Tsuji
authors: Kaori
authors: K
authors: Yanagitani
authors: Masaaki
authors: M
authors: Shimatani
authors: Nobuyuki
authors: N
authors: Shibatani
authors: Yoshihito
authors: Y
authors: Imai
authors: Shoichiroh
authors: S
authors: Takamidoh
authors: Kyoichi
authors: K
authors: Inoue
mesh_terms: D000368:Aged; D001646:Bile / Q000378:metabolism*; D001652:Bile Ducts / Q000378:metabolism*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000378:metabolism* / Q000601:surgery*; D019299:Decompression, Surgical; D004322:Drainage; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D013845:Thienamycins / Q000493:pharmacokinetics*
chemical_list: D013845:Thienamycins; C039536:panipenem