Abstract
The excretion of cefotetan, a 7α-methoxycephalosporin, was studied in 27 patients undergoing biliary surgery. Pharmacokinetic parameters were determined after a single intravenous bolus dose of 1 g (10 patients) or 2 g (17 patients). Rapidly excreted in bile, cefotetan concentrations were considerably higher in bile [range: 92–2,594 mg·l−1 (1 g); 35–4,610 mg·l−1 (2 g)] than in plasma despite the presence of gall stones. Bile bactericidal activities againstStaphylococcus aureus (MIC 8 mg·l−1) andBacteroides fragilis (MIC 2 mg·l−1) correlated well with gall bladder cefotetan levels [r = 0.888 (1 g);r = 0.971 (2 g)]. No cefotetan was detected in the bile of 3 patients with nonfunctioning gall bladders. One other patient with very low activity and these three aside, the inhibitory quotients (cefotetan concentration/MIC) were >4 for both doses against both bacteria.
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Adam HK, Houghton HL, Yates RA, Young J, Donnelly RJ. Pharmacokinetics and tolerance of a 24 h infusion of cefotetan disodium (with and without loading dose) in normal Caucasian volunteers. J Antimicrob Chemother 1983;11:193–9.
Courvalin P, Goldstein F, Philippon A, Sinot J. L'antibiogramme. 3rd ed. Paris: MPC Videom, 1985:195–8, 219–24.
Ellner PD, Neu HC. The inhibitory quotient. A method for interpreting minimum inhibitory concentration data. JAMA 1981;246:4.
Yates RA, Adam HK, Donnelly RJ, Houghton HL, Charlesworth EA, Laws EA. Pharmacokinetics and tolerance of single intravenous dose of cefotetan disodium in male Caucasian volunteer. J Antimicrob Chemother 1983;11:185–91.
Owen AW, Manson JM, Yates RA, Adshead VM, Houghton HL, Tweedle DE. The pharmacokinetics of cefotetan excretion in the unobstructed biliary tract. J Antimicrob Chemother 1983;11:217–21.
Kees F, Strehl E, Dominiak P, Grobecker H, Seeger K, Seidel G, et al. Cefotaxime and desacetyl cefotaxime in human bile. Infection 1983;11:118–20.
Grion JA, Meyers BR, Hirschman SZ. Biliary concentrations of piperacillin in patients undergoing cholecystectomy. Antimicrob Agents Chemother 1981;19:309–11.
Ratzan KR, Baker HB, Lauredo I. Excretion of cefamandole, cefazolin and cephalothin into T-tube bile. Antimicrob Agents Chemother 1978;13:985–7.
Martinez OV, Levi JU, Malinin Tl, Zeppa R. In: Program Abstracts of the Interscience Conference on Antimicrobial Agents Chemotherapy. Las Vegas; Nevada; 1983. Washington: American Society of Antimicrobial Agents Chemotherapy, 1983:abstract 709.
Neu HC. A review and summary of the pharmacokinetics of cefoperazone: a new extended spectrum of beta-lactam antibiotics. Ther Drug Monitor 1981;3:121–8.
Levi JU, Livingstone A, Martinez OV, Zeppa R, Malinin Tl, Hutson D, et al. Biliary concentrations of cefamandole and its use in biliary tract surgery. Scand J Infect Dis 1981;25 Suppl:55–7.
Ratzan KR, Ruiz C, Irvin GL. Biliary tract excretion of cefazolin, cephalothin and cephaloridine in the presence of biliary tract disease. Antimicrob Agents Chemother 1974;6:426–31.
Strasberg SM, Harvey RPC, Hofmann AF. Bile sampling, processing and analysis in clinical studies. Hepatology 1990;12:176S-82S.
Ahrendt SA, Magnusson TH, Pitt HA, Lillemoe KD. Effect of cholecystectomy on gallbladder bile composition. Dig Dis Sci 1992;37:1232–5.
Martinez OV, Levi JU, Devlin RG. Biliary excretion of aztreonam in patients with biliary tract disease. Antimicrob Agents Chemother 1984;25:358–61.
Leung JWC, Chan CY, Lai CW, Ko TC, Cheng AFB, French GL. Effect of biliary obstruction on the hepatic excretion of imipenem-cilastatin. Antimicrob Agents Chemother 1992;36:2057–60.
Tera H. Stratification of human gallbladder bilein vivo. Acta Chir Scand 1960;256 Suppl:4–85.
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Cherrier, P., Perrin, P., Gueye, S. et al. Pharmacokinetics and clinical study of cefotetan in bile: Prophylactic use in biliary tract surgery. Pharm World Sci 15, 79–82 (1993). https://doi.org/10.1007/BF01874087
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DOI: https://doi.org/10.1007/BF01874087