CHEMOTHERAPY OF BILIARY INFECTIONS (REPORT III) BILIARY EXCRETION AND TISSUE CONCENTRATION IN THE GALLBLADDER IN PATIENTS TREATED WITH CEFOXITIN

• Published in: CHEMOTHERAPY Vol. 26; no. Supplement1; pp. 412 - 428
• Main Authors: KINOSHITA, KEN-ICHI, TANIMURA, HIROSHI, MUKAIHARA, SUMIO, MAJIMA, MASANORI, SETOYAMA, MOTOICHI, MARUYAMA, IZUMI, MARUYAMA, KEISUKE, KAMATA, TOSHIO, YASUTOMI, TOORU, MATSUMOTO, HIROMI, MATSUDA, SUSUMU, TAKENAKA, MASAFUMI, NAGASE, MASAO, OKAMOTO, MIHOJI, HIKASA, YORINORI, KURAHASHI, MICHIO
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 31.03.1978
• ISSN: 0009-3165; 1884-5894
• DOI: 10.11250/chemotherapy1953.26.Supplement1_412

The clinical effects of cefoxitin (CFX), a new semisynthetic cephamycin antibiotic, were studied in patients with biliary tract infections, and the results obtained were as follows: 1) Concentrations of CFX in gallbladder bile and tissue were measured 2 hours after the intravenous injection of cefoxitin (2 g) in patients operated for cholecystectomy. Concentrations of CFX in the gallbladder bile and tissue averaged 127μg/ml and 26μg/g, respectively, in 13 cases without cystic duct obstruction. In 11 cases with cystic duct obstruction, the concentration in bile and tissue averaged 24μg/ml and 25μg/g, respectively. 2) The concentrations of CFX in the gallbladder bile were observed in 10 cases. Maximum biliary concentrations appeared within 1 or 2 hours after administration, thereafter decreasing rapidly. Crossover treatment was performed to compare the concentrations of CFX in gallbladder bile with those of CEZ (cefazolin). The results revealed that the concentration of CFX was slightly lower than that of CEZ 3 to 5 hours after administration. 3) Biliary recovery rates of CFX and CEZ, within 6 hours after treatment, were 0.09-0.41% and 0.07-4.24%, respectively. One case given CEZ had no measurable concentrations within 6 hours. The reason was considered to be inactivation by beta-lactamase. 4) The clinical effects were excellent in 4 and good in 18 out of 25 cases; the clinical efficacy rate being 88. 0% except for patients with malignant jaundice. CFX was effective in 2 cases in the treatment of patients who showed adverse reactions to CEZ. 5) All 59 cases given CFX showed neither positive cutaneous nor allergic reactions. A case of elevated BUN was not aggravated by CFX treatment.