Chemotherapy of biliary tract infection (35) : Biliary excretion of cefteram pivoxil
Tanimura, H.; Nagai, Y.; Aoki, Y.; Matsumoto, H.; Ohtani, H.; Henmi, K.; Sawada, H.; Mukaihara, S.; Honda, K.; Kato, D.
Nihon Geka Hokan. Archiv für Japanische Chirurgie 57(5): 400-412
1988
ISSN/ISBN: 0003-9152 PMID: 3251426 Document Number: 311430
Biliary excretion of cefteram pivoxil (CFTM-PI), a new oral cephalosporin, was studied in 9 patients with an indwelling T-tube by the crossover method after oral administration of 200 mg of CFTM-PI alone, or in combination with 300 mg of ursodeoxycholic acid (UDCA) or 100 mg of aclatonium napadisilate (Abovis), an activator of gastrointestinal motility. The results were as follows: 1) In 8 cases, excluding a gastrectomized case, biliary CFTM concentration reached a peak between 4 and 7 hr after administration when CFTM-PI was given alone. The highest mean concentration in bile 13.6 .mu.g/ml, being markedly high compared with the blood concentration. 2) T-2525A, a metabolite of CFTM, was detected by HPLC in the bile in 7 of 9 cases. In 5 cases given CFTM-PI alone, total 12-hr biliary recovery rates of T-2525A were 1.61 to 25.0% of the CFTM dose. However, in patients who had undergone transduodenal sphincteroplasty, and gastrectomy the rates were 36.1% and 59.2%, respectively. 3) In a patient who had undergone transduodenal sphincteroplasty, the peak biliary CFTM concentration appeared wihtin 2 hr after administration, similar to that of blood and urinary concentrations when it was administered in combination with Abovis. The results indicate that CFTM-PI is effective in the treatment of biliary tract infection. However, further studies are required to determine the administration method for each disease type, since combined use of UDCA or gastrointestinal motility activating agent influences the pharmacokinetics of CFTM-PI.