1983 Volume 31 Issue 11 Pages 1042-1046
Choledocal bile was collected every 30 or 60 minutes from 14 patients under T-tube drainage and 2 patients under PTC drainage, to study how antibiotics penetrate into biliary system. Ceftazidime (CAZ) and cefazolin (CEZ) were used for this study. Three groups were set up for each drug;(a) bolus injection of 1g intravenously (1g iv), (b) bolus injection of 2g intravenously (2g iv), (c) drip infusion of 2g intravenously for 60 minutes (2g div). The concentration of antibiotics was measured by the thin layer disc method.
The peak concentration and the recovery rate in bile was as follows (1) CAZ 1g iv (n=9) 27.6μg/ml, 0.39%, (2) CAZ 2g iv (n=4) 36.7μg/ml, 0.30%, (3) CAZ 2g div (n=5) 37.6μg/ml, 0.30%, (4) CEZ 1g iv (n=8) 14.3μg/ml, 0.07%, (5) CEZ 2g iv (n=7) 34.6μg/ml, 0.07%, (6) CEZ 2g div (n=5) 12.5μg/ml, 0.03%. That is, the more the dose of antibiotics was, the higher the concentration of antibiotics in bile was. Though the result of CAZ 2g iv was similar to that of CAZ 2g div, the result of CEZ 2g iv was evidently better than that of CEZ 2g div. On timeconcentration curve, the peak of CEZ was sharp, but that of CAZ showed plateau for 5 to 6 hours.
So, it was suggested that CAZ may be administered 1g or 2g, twice a day and CEZ should be administered 2g, 3 times a day. On the other hand, it was suspected that bolus injection might be superior to drip infusion, for the penetration of antibiotics into bile.
