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Bile loss does not affect serum and bile pefoloxacin levels in external biliary drainage patients
Author(s) -
Kotzampassi K.,
Nikolaidis P.,
Tzartinoglou E.,
Farmakis H.,
Liltsis G.,
Aletras H.
Publication year - 1995
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02350908
Subject(s) - cholecystectomy , common bile duct , medicine , gastroenterology , bile duct , duodenum , pefloxacin , antibiotics , biology , ofloxacin , ciprofloxacin , microbiology and biotechnology
Although the excretion of an antibiotic into the bile is an important factor for the therapy of patients suffering biliary infections, recent findings suggest that external biliary drainage of the obstructed biliary tree leads to a progressive reduction of the antibiotic levels in the excreted bile, probably due to bile loss. Since pefloxacin, a broad spectrum antibiotic excreted mainly into the bile, seems to be useful for such infections, it would be of great interest to investigate its concentration human serum and bile throughout a 6‐day treatment. Fourteen biliary lithiasis patients were enrolled in the study; 7 were subjected to cholecystectomy (group A) and 7 to cholecystectomy plus common bile duct exploration and 7 to cholecystectomy plus common bile duct exploration and external biliary drainage through a specially diesgned custommade T‐tube (group B). The distal end of the horizontal part of this tube could be occluded by the incorporation of an inflatable ballon, thus facilitating the complete diversion of the bile flow from the duodenum. Pefloxacin was given intravenously at a single loading dose of 800 mg, followed, after 24h, by 400 mg bi.i.d. for 5 days. Blood and bile (group B only) saples were obtained before and at various time intervals after drug infusion. Pefloxacin assays, detemined by high performance liquid chromatography, revealed no variation in perfoxacin concentrations in the bile throughout the entire study period, despite a bile loss of about 700 ml daily. Serum levels in both groups ad bile levels in group B wer found to be equally high, being many times above the minimum inhibitory concentrations for sensitive pathogens. Additionally, the elimination half‐life of pefloxacin was found to be similar for both groups (25.5±6.7 h vs 27.9±15.6h, for goups A and B, respectively). It is concluded that bile loss does not affect serum and bile pefloxacin levels in patients subjected to external biliary drainage.