Abstract
Forty patients underwent elective cholecystectomy following administration of a single intravenous dose of cefazolin, ceftriaxone, cefoperazone, or ceftazidime. Mean gallbladder bile concentrations of cefoperazone (398.8μ g/ml and ceftriaxone (153.4 μg/ml) were significantly higher than those of cefazolin (12.3 μg/ml) and ceftazidime (3.08 μ g/ml) (p<0.008). Mean gallbladder tissue levels of cefazolin (30.1 μ g/g), ceftriaxone (50.5 μ g/g), and cefoperazone (91.0 μ g/g) exceeded that of ceftazidime (7.25 μ g/g) (p<0.001). When adjusted for known in vitro activity against biliary pathogens, these data suggest that cefoperazone and ceftriaxone are superior to ceftazidime and cefazolin for prophylaxis in elective biliary surgery.
Résumé
Quarante patients ont été cholécystectomisés après administration intraveineuse d'une dose unique de céfazoline, de ceftriaxone, de céfapérazone ou de ceftazidine. La concentration moyenne de la bile vésiculaire en céfopérazone (398.8μg/ml) et en ceftriaxone (153.4μg/ml) était significativement plus élevée que la concentration en céfazoline (12.3μg/ml) et en ceftazidine (3.08μg/ml) (p<0.008). Les concentrations tissulaires vésiculaires moyennes de céfazoline (30.1μg/g), de ceftriaxone (50.5μg/g), et de céfopérazone (91.0μg/g) étaient plus importantes que la concentration de ceftazidine (7.25μg/g) (p<0.001). Lorsque ces antibiotiques sont sensibles in vitro contre des germes pathogènes, nos résultats suggèrent que le céfopérazone et la ceftriaxone sont meilleurs que la ceftazidine et la céfazoline dans la prophylaxie antibiotique de la chirurgie biliaire élective.
Resumen
Las nuevas cefalosporinas “de tercera generación” poseen actividad contra una variedad de bacterias, incluso la mayoría de los patógenos biliares comunes. Hemos realizado un estudio prospectivo sobre el grado de penetración de la cefazolina, la ceftriaxona, la cefoperazona, y la ceftazidima en el tejido y la bilis de la vesícula biliar en pacientes sometidos a colecistectomía electiva.
Cuarenta pacientes recibieron una dosis única de la cefalosporina dentro de la hora anterior a la colecistectomía. Las concentraciones medias en la bilis de la vesícula biliar fueron significativamente mayores para la cefoperazona (398.8μg/ml) y la ceftriaxona (153.4μg/ml) que para la cefazolina (12.3μg/ml) y la ceftazidima (3.08μg/ml) (p<0.008). Los niveles medios en el tejido de la vesícula biliar fueron superiores para la cefalozina (30.1μg/g), la ceftriaxona (50.5μg/g), y la cefoperazona (91.0μg/g que para la ceftazidima (7.25μg/g) (p<0.001). Al ajustar estos datos contra valores conocidos de actividad in vitro contra patógenos biliares, aparece que la cefoperazona y la ceftriaxona son superiores a la ceftazidima y la cefazolina en cuanto a profilaxis en cirugía biliar electiva.
Similar content being viewed by others
References
Nagar, H., Berger, S.A.: The excretion of antibiotics by the biliary tract. Surg. Gynecol. Obstet.158:601, 1984
Bouza, E., Hellin, T., Rodriguez-Creixems, M., Martinez-Beltran, J., Loza, E., Baquero, F.: Comparison of ceftazidime concentrations in bile and serum. Antimicrob. Ag. Chemother.24:104, 1983
Kemmerich, B., Lode, H., Borner, K., Belmega, D., Jenderoschek, T., Koeppe, P., Goertz, G.: Biliary excretion and pharmacodynamics of cefoperazone in humans. J. Antimicrob. Chemother.12:21, 1983
Arvidsson, A., Alvan, G., Angelin, B., Borga, O., Nord, C.E.: Ceftriaxone: Renal and biliary excretion and effect on the colon microflora. J. Antimicrob. Chemother.10:207, 1982
Ratzan, K.R., Baker, H.B., Lauredo, I.: Excretion of cefamandole, cefazolin and cephalothin into T-tube bile. Antimicrob. Ag. Chemother.13:985, 1978
Nakamura, T., Hashimoto, I., Sawada, Y., Mikami, J., Bekki, E., Hirasawa, S., Abe, H., Watanabe, Y.: Cefoperazone concentrations in bile and gallbladder wall after intravenous adminstration. Antimicrob. Ag. Chemother.18:980, 1980
Wittman, D.H., Schassan, H.H., Seibert, W.: Pharmacokinetic studies of ceftazidime in serum, bone, bile, tissue fluid and peritoneal fluid. J. Antimicrob. Chemother.8[Suppl.]:293, 1981
Wright, W.E., Line, V.D.: Biliary excretion of cephalosporins in rats; influence of molecular weight. Antimicrob. Ag. Chemother.17:842, 1980
Hamilton-Miller, J.M.T.: Comparative activity of ampicillin and seven cephalosporins against group D streptococci. J. Clin. Pathol.27:828, 1974
Kucers, A., Bennett, N.M., editors: Cephazolin and cephacetrile. In The Use of Antibiotics, Philadelphia, J.B. Lippincott, 1979, p. 241
Fujimoto, T., Otani, T., Nakajima, R., Une, T., Osada, Y.: In vitro activity of DG-2556, a new cephalosporin. Antimicrob. Ag. Chemother.30:611, 1986
Thomas, M.G., Lang, S.D.R.: Antimicrobial spectrum of Ro 15-8074/001, a new oral cephalosporin. Antimicrob. Ag. Chemother.30:611, 1986
Jones, R.N., Ayres, L.W., Gavan, T.L., Gerlach, E.H., Sommers, H.M.: In vitro comparative antimicrobial activity of cefpimizole against clinical isolates from five medical centers. Antimicrob. Ag. Chemother.27:982, 1985
Neu, H.C., Meropal, N.J., Fu, K.P.: Antibacterial activity of ceftriaxone (RO 13-9904), a lactamase-stable cephalosporin. Antimicrob. Ag. Chemother.19:414, 1981
Une, T., Otani, T., Sato, M., Ikeuchi, T., Osada, Y., Ogawa, H., Sato, K., Mitsunashy, S.: In vitro and in vivo activities of DN-9550, a new broad spectrum cephalosporin. Antimicrob. Ag. Chemother.27:473, 1985
Kees, F., Strehl, E., Dominiak, P., Grobecker, H., Seeger, K., Seidel, G., Neuhaus, B., Safrani, L.: Cefotaxime and desacetyl cefotaxime in human bile. Infection11:118, 1983
Kaiser, A.B.: Antimicrobial prophylaxis in surgery. N. Engl. J. Med.315:1129, 1986
Keighley, M.R.B.: Infection and the biliary tree. In The Biliary Tract, L.H. Blumgart, editor, Edinburgh, Churchill Livingstone, 1982, pp. 219–235
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Berger, S.A., Levy, Y., Halevy, A. et al. Penetration of cefazolin, ceftriaxone, cefoperazone, and ceftazidime into human gallbladder tissue and bile. World J. Surg. 12, 641–644 (1988). https://doi.org/10.1007/BF01655872
Issue Date:
DOI: https://doi.org/10.1007/BF01655872