Excretion of cefazolin in bile was determined in patients with biliary tract diseases. In the first experiment bile was collected mainly through T tube postoperatively. Second, the concentration of the drug in gallbladder bile, common bile duct bile and gallbladder tissue were measured intraopera-tively and the following results were obtained.
Postoperative Study.
1. The levels of CEZ in the T tube bile after 1 and 2 g intramuscular administration in patients with normal liver function were higher than in those with hepatic dysfunction.
2. Biliary excretion of CEZ after 1 g intravenous administration was unsatisfactory. In the cases of 2 g. intravenous administration, the highest concentration occurred immediately after 30-60 minutes after injection, but the levels were not maintained as long as those of intramuscular administration.
3. Drip infusion of 2 g of CEZ over a period of 2 hours, showed relatively high concentration which persisted for 6 hours. Drip infusion was considered to be useful to maintain effective therapeutic levels.
4. In one patient, biliary excretion of CEZ was compared with that of ABPC. CEZ was excreted in slightly higher level than ABPC.
Intraoperative Study.
5. CEZ levels in gallbladder bile and gallbladder tissue varied in different individuals and were considered to be dependent on the degree of inflammation of gallbladder. But even in patients with strongly inflamed gallbladder the levels of 4. 3, -12.0 μg/g were observed in the gallbladder wall, sug-gesting the effectiveness of CEZ for cholecystitis.

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The concentration of HI-63 in human bile was measured in 3 patients with common bile duct drainage for cholelithiasis. After a single intramuscular injection of 1 g of the drug, average biliary levels were 1.48±1.93, 2.55±2.45, 6.82±2.36, 5.50±1.65, 3.23±2.03 and 3.92±3.11, ug/ml at 1, 2, 3, 4, 6 and 8 hours, respectively. The highest individual peak was 9.50, ug/ml and the lowest was 3.75, ug/ ml. Thus a rather slower rate of decrease in the biliary level was observed.
Clinical applications of HI-63 were performed to 20 cases with cholelithiasis. The results on 13 patients were good in 11 and poor in 2. Those on 7 patients with associated acute cholangitis were excel-lent in 1, good in 5 and poor in 1. An over-all proportion of the effectiveness was 85%. Any side effects were observed in none of the cases.Table 4 Bacteria isolated from bile samples in patient with.cholelithiasis

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