[Cefmenoxime transport into the bile, especially in the intra- and postoperative periods]

Using 13 patients undergoing operation of the bile duct, cefmenoxime (CMX) transport into the bile and the gallbladder tissue was investigated. One gram of CMX was administered through drip infusion over 30 minutes every 12 hours. CMX concentration in bile was measured for samples surgically collected about 103 minutes (75-141 minutes) after the start of CMX administration. CMX concentrations in bile samples collected from gallbladder were found to be as high as 326.6 +/- 432.3 micrograms/ml in patients with neither jaundice nor cystic duct obstruction, indicating sufficient CMX transport. When cystic duct obstructions were present, CMX concentrations were very low, or moderately low if jaundice was also present. Changes in CMX concentration were then measured over 6 hours after administration in patients with an external biliary fistula every other day for a period of 7 days, from the first postoperation day. As for horal changes, CMX concentration reached its peak in 2 hours after the start of administration in most cases. Maximum CMX concentrations in patients without jaundice were high, ranging from 313.3 to 1,232.3 micrograms/ml (mean, 641.2 micrograms/ml), and CMX was found at 4.0-76.6 micrograms/ml (mean, 37.4 micrograms/ml), even after 6 hours. As for diurnal changes, CMX was determined to be sufficiently transported into the bile from the first postoperation day. Although CMX concentrations tended to be lower on the fifth postoperation day than on other days, there was no statistical significance in differences in daily concentrations examined. CMX concentrations in gallbladder tissues were determined to be 22.7 4/- 32.1 micrograms/g, and they decreased over time exponentially.