[Pharmacokinetics of the biliary excretion of some chemotherapeutic agents in patients with biliary disease]. / Farmacocinetica dell'escrezione biliare di alcuni chemioterapici in pazienti con patologia biliare.

The authors have assessed the concentration of 7 antibiotics in the bile of patients undergoing biliary surgery or carriers of a T tube in the common bile duct. 1 hour preoperatively, 122 patients were administered with the following chemotherapeutic agents: Cefoxitin 2 g i.v.; Cefamandole 2 g i.v.; Ceftriaxone 1 g i.v.; Clindamycin 600 mg i.v.; Amikacin 500 mg i.v.; Gentamycin 160 mg i.v.; Norfloxacin 400 mg by mouth; 30 patients showed obstructive jaundice or obstructed cystic duct. Samples of bile were withdrawn from gallbladder and common bile duct. The same antibiotics were administered to 81 patients carrying a T tube. Samples of bile and serum were collected at baseline and every 30 minutes for 4 hours and subsequently at 12 and 24 hours following administration. 18 patients showed altered liver function tests. The chemotherapeutic agents were tested by the microbiological assay as well as by HPLC. Mean concentration in the gallbladder bile was: Cefoxitin 209 +/- 86 micrograms/ml; Cefamandole 436 +/- 108 micrograms/ml; Ceftriaxone 482.7 +/- 214.84 micrograms/ml; Clindamycin 64 +/- 22 micrograms/ml; Amikacin 5 +/- 1.4 micrograms/ml; Gentamycin 4 +/- 2 micrograms/ml; Norfloxacin 22 +/- 14 micrograms/ml. In the bile of jaundiced patients or with non-visualized gallbladder no antibiotics were detected.(ABSTRACT TRUNCATED AT 250 WORDS)

Cefoxitin and cefamandole levels in the human bile.

The bile levels of cefoxitin and cefamandole were studied in 75 patients. The two antibiotics were shown to be present at high concentration and to undergo a rapid metabolization. It is concluded that they represent the antibiotics of choice in the prophylactic and therapeutic treatment of biliary tract infections.