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[Clinical studies with cefoperazone in the biliary disease]
The Japanese Journal of Antibiotics
|January 1, 1985
Summary
Cefoperazone (CPZ) shows higher and longer-lasting concentrations in bile compared to Cefazolin (CEZ) after intravenous administration. CPZ also demonstrates superior in vitro activity against Gram-negative bacilli, with no observed side effects.
Area of Science:
- Pharmacology
- Infectious Diseases
- Surgical Infections
Background:
- Gallstone diseases often necessitate surgical intervention, increasing the risk of post-operative infections.
- Effective antibiotic prophylaxis and treatment are crucial in patients undergoing biliary tract surgery.
- Understanding the pharmacokinetic profiles and antimicrobial spectrum of antibiotics in surgical patients is vital.
Purpose of the Study:
- To compare the serum and bile concentrations of cefoperazone (CPZ) and cefazolin (CEZ) after intravenous administration in patients with gallstone diseases.
- To evaluate the in vitro antimicrobial activity of CPZ and CEZ against relevant bacterial pathogens.
- To assess the safety and tolerability of CPZ in this patient population.
Main Methods:
- Eleven patients undergoing cholecystectomy, choledocholithotomy, and T-tube drainage received 1g intravenous drip infusion of either CPZ or CEZ.
- Serum and bile concentrations were measured at various time points post-infusion.
- Minimum inhibitory concentrations (MICs) of CPZ and CEZ were determined for Gram-positive cocci and Gram-negative bacilli.
Main Results:
- CPZ achieved significantly higher and more sustained concentrations in bile compared to CEZ (mean bile concentration of CPZ approx. 30 times higher than CEZ).
- CPZ demonstrated a longer serum concentration maintenance period than CEZ.
- CPZ exhibited lower MIC values against Gram-negative bacilli compared to CEZ, while activity against Gram-positive cocci was comparable. No side effects were reported.
Conclusions:
- Cefoperazone offers superior pharmacokinetic advantages in bile and enhanced in vitro activity against Gram-negative pathogens compared to cefazolin in patients with gallstone diseases.
- CPZ is a potentially more effective antibiotic option for preventing or treating infections associated with biliary tract surgery.
- The favorable safety profile of CPZ supports its clinical utility in this surgical context.