Excretion of an Antibiotic into Human Bile in Patients with Obstructive Jaundice

Kiyoshi Sakuraba, Takehiko Soeno, Seiji Ito, Kozo Suzuki, Kazuo Shindo, Naoki Mizuguchi*, Masato Takeda*, Tsuyoshi Mukojima*

Department of Surgery, Akita City Hospital
*Department of Gastroenterology, Akita Medical Center

Excretion of an antibiotic into human bile as well as various factors influencing the excretion were studied in 10 patients with obstructive jaundice. In this study the antibiotic cefpiramide (CPM) was used. When the bile duct was completely obstructed, CPM was never excreted. However, it was excreted relatively soon after release of the biliary obstruction. The rate of excretion of CPM in the presence of obstrucitve jaundice appeared to be strongly affected by the state of bile flow. After release of the biliary obstruction, a statistically significant negative relationship between the maximum CPM concentration in the bile and the total serum bilirubin level (p<0.05) was shown. Thus the excretion of CPM into the bile might decrease with advance in the severity of jaundice. Moreover, the possibility that fibrosis of Glisson's capsule and blood supply to the liver might affect the rate of excretion of the antibiotic into the bile is suggested, because the maximum biliary CPM concentration tended to correlate with the K value in the indocyanine green test.

Key words
obstructive jaundice, excretion of antibiotics into bile, Cefpiramide, percutaneous transhepatic biliary drainage, ICG disappearance rate

Reprint requests
Kiyoshi Sakuraba Department of Surgery, Akita City Hospital
4-30 Kawamotomatsuoka-cho, Akita City, 010 JAPAN

Accepted
June 13, 1990

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