The pharmacokinetics of cefotetan excretion in the unobstructed biliary tree

Cefotetan excretion was studied in 17 patients undergoing biliary or pancreatic surgery. The antibiotic was detected in bile taken from the common bile duct within 15 min of a 1 g iv bolus and therapeutic plasma levels were found up to 10 h after administration. Even higher concentrations of cefotetan were measured in the bile from functioning gall bladders, despite the presence of gall stones. Concentrations of cefotetan in bile from the common bile ducts and functioning gall bladders were greater than the plasma concentrations at all times. These concentrations exceed the in-vitro minimum inhibitory concentrations (MIC) for most common biliary tract pathogens.