[Clinical effect of cefmenoxime on cholecystitis; its clinical efficacy and tissue concentration]

A new antibiotic drug of cephalosporin, with marked resistance to beta-lactamase, cefmenoxime (CMX) for parenteral use was used in 14 patients with acute or subacute cholecystitis and cholangitis. CMX was given by intramuscular or intravenous drip infusion at a daily dose of 500 mg to 2 g. Clinical response was excellent in 3 cases, good in 10 cases, fair in 1 case and poor in none. Any clinical adverse effect was not recognized. CMX in a dose of 500 mg was given by intramuscular administration before the operation to 8 patients, and in 7 cases CMX in a dose of 1 g was given by intravenous administration before or during the operation. Tissue specimens of different sites were taken from the removed organs. The materials of A-bile and B-bile were subsequently taken at intervals. CMX concentrations in the A-bile increased after intramuscular injection and reached to peak 2 hours, then declined very slowly. CMX concentrations in the A-bile after intravenous administration reached to peak at 1 hour, then declined very slowly, too. CMX concentration in the B-bile reached to high level of the concentration comparative quickly after intramuscular and intravenous administration, and it was thought to be excreted through the gallbladder wall. CMX concentration in the gallbladder wall was directly proportional to the degree of pathological changes of the inflammation. On the CMX concentration in patients with cholecystitis and cholangitis, the concentration in A-bile, B-bile and gallbladder wall were observed higher than the MIC of CMX for pathogenic Gram-negative bacilli. CMX therefore will be a very useful drug when used for chemotherapy of the infectious diseases of the biliary tract.