[Study of lincomycin concentrations in hepatocystic duct]

Penetration of lincomycin (LCM) in choledochal and cholecystic bile as well as in the gallbladder tissue and liver tissue was investigated together with bacteria detectable in the bile in order to evaluate basically usefulness of this antibiotic in the treatment of infections of the hepatocystic duct. Intravenous drip infusion of LCM 1.5 g (in 500 ml of 5% glucose solution) over 1.5--2 hours resulted in mean drug concentrations of 33.9 and 10.1 micrograms/ml in serum at 2 and 4 hours post start of infusion respectively; 215.5 micrograms/ml in choledochal bile at 3 hours 15 minutes; 252.7 micrograms/ml in cholecystic bile at 3 hours 36 minutes; 28.1 micrograms/g in gallbladder tissue at 2 hours 55 minutes; and 15.4 micrograms/g in liver tissue at 4 hours. A cross-over study of LCM and cefazolin (CEZ) in 2 cases where T-tubes were employed demonstrated evidently higher biliary levels of LCM than CEZ. Bacteriological examination showed that Hafnia alvei plus Streptococcus faecalis were presented in choledochal bile from just 1 of 4 cases while in cholecystic bile from 9 of 15 cases were detected 22 strains of organisms including Klebsiella pneumoniae (7 strains), Bacteroides fragilis (5), Escherichia coli (2), Citrobacter freundii (2) and Serratia marcescens (2). A total of 7 strains of anaerobes including B. fragilis was isolated. The above concentrations of LCM in the bile, gallbladder tissue and liver tissue sufficiently covered the MIC90 of this antibiotic determined by us in 1980 for major species of anaerobes including clinical isolates of B. fragilis.(ABSTRACT TRUNCATED AT 250 WORDS)