Temocillin concentrations were determined in the gallbladder bile and/or common bile duct bile obtained intraoperatively from 20 patients, and in the T-tube bile of 5 postoperative patients. Blood samples were also obtained for determining the concomitant serum antibiotic concentrations.
In 6 patients with cholelithiasis, but without common bile duct obstruction or acute infection, the mean temocillin concentrations were 890 mg/L in gallbladder bile and 1030 mg/L in common bile duct bile. In the group of 6 patients with common bile duct obstruction, the antibiotic concentrations ranged between 5.6 and 88 mg/L (mean 38.8 mg/L) in gallbladder bile and between ‘undetectable’ and 700 mg/L in common bile duct bile. In patients with biliary sepsis, a further reduction in temocillin bile concentrations was observed, and postoperatively, the T-tube bile temocillin concentrations were in the range of 21 to 460 mg/L (mean 130 mg/L). The clinical efficacy of temocillin in the 7 patients with acute cholecystitis was judged to be satisfactory. Our results suggest that temocillin may be considered as a potentially useful antibiotic in the treatment of patients with biliary tract sepsis caused by susceptible organisms.
McLeish, A.R.; Strachan, C.J.L.; Powis, S.J.A.; Wise, R. and Bevan, P.G.: The influence of biliary disease on the excretion of cefazolin in human bile. Surgery 81: 426–430 (1977).
Mortimer, P.R.; Mackie, D.B. and Haynes, S.: Ampicillin levels in human bile in the presence of biliary tract disease. British Medical Journal 3: 88–89 (1969).
Steers, E.; Foltz, E.L.; Graves, B.S. and Riden, J.: An inocula replicating apparatus for routine testing of bacterial susceptibility to antibiotics. Antibiotics and Chemotherapy 9: 307–311 (1959).
Thomas, M.: Antibiotics in bile. Journal of Antimicrobial Chemotherapy 12: 419–422 (1983).
Uwaydah, M.; Kantarjian, H.; Osseiran, M. and Bal’a, F.: Cefamandole bile levels in patients with hepatobiliary disease. Antimicrobial Agents and Chemotherapy 22: 1087–1089 (1982).
Uwaydah, M.; Najjar, F.; Vartivarian, S. and Harakeh, H.: Temocillin bile levels. Journal of Antimicrobial Chemotherapy. 14: 193–194 (1984).
About this article
Cite this article
Uwaydah, M., Vartivarian, S., Harakeh, H. et al. Potential Role of Temocillin in the Treatment of Biliary Sepsis. Drugs 29, 186–190 (1985). https://doi.org/10.2165/00003495-198500295-00040
- Common Bile Duct
- Acute Cholecystitis
- Biliary Tract Disease
- Gallbladder Bile