[Biliary excretion of mezlocillin]
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Abstract:
2 g of mezlocillin were given at different time intervals (1/4, 1/2, 1, 2, 4, 10, 14, 18 hours) to patients in whom endoscopic retrograde cholangiography (ERC) was scheduled for antibiotic prophylaxis. Prior to the instillation of the contrast medium 5 ml of bile were aspirated and the concentration of the antibiotic determined via agar diffusion in comparison to the serum level. Serum levels reached a peak of 105 micrograms/ml whereas bile levels reached a mean level of 4000 micrograms/ml. In patients with intact liver function mezlocillin is concentrated to a factor of 40 within bile. Complete elimination in serum occurs after 4 to 5 hours, in bile after 18 to 24 hours.
Insights
Mezlocillin antibiotic prophylaxis concentrates 40-fold in bile after endoscopic retrograde cholangiography. Bile antibiotic levels remain significantly higher than serum levels for up to 24 hours.
Area of Science:
- Pharmacokinetics and Drug Metabolism
- Gastroenterology
- Infectious Diseases
Context:
- Antibiotic prophylaxis is crucial for procedures like endoscopic retrograde cholangiography (ERC).
- Understanding drug concentration in bile is essential for effective treatment and prophylaxis in hepatobiliary conditions.
Purpose:
- To determine the concentration of mezlocillin in bile and serum following administration for antibiotic prophylaxis during ERC.
- To assess the pharmacokinetic profile of mezlocillin in bile compared to serum.
Summary:
- Patients received 2g of mezlocillin at various intervals before ERC.
- Bile and serum samples were analyzed for mezlocillin concentrations.
- Mean bile concentration reached 4000 micrograms/ml, a 40-fold increase compared to peak serum levels (105 micrograms/ml).
- Complete elimination from serum occurred in 4-5 hours, while elimination from bile took 18-24 hours.
Impact:
- Demonstrates significant concentration of mezlocillin in bile, suggesting potential efficacy for biliary tract infections.
- Provides crucial data on mezlocillin's pharmacokinetic behavior in the biliary system.
- Informs optimal dosing strategies for antibiotic prophylaxis and treatment in patients undergoing ERC or with biliary conditions.