Assessment of biliary excretion of piperacillin-tazobactam in humans
| العنوان: | Assessment of biliary excretion of piperacillin-tazobactam in humans |
|---|---|
| المؤلفون: | François Jehl, Henri Monteil, F. Caro-Sampara, J. F. Westphal, M Adloff, Brogard Jm, Blickle Jf |
| المصدر: | Antimicrobial Agents and Chemotherapy. 41:1636-1640 |
| بيانات النشر: | American Society for Microbiology, 1997. |
| سنة النشر: | 1997 |
| مصطلحات موضوعية: | Adult, Male, Tazobactam, medicine.medical_specialty, medicine.medical_treatment, Penicillanic Acid, Penicillins, Gastroenterology, Excretion, Internal medicine, polycyclic compounds, medicine, Bile, Humans, Cholecystectomy, Pharmacology (medical), Enzyme Inhibitors, Antibacterial agent, Piperacillin, Pharmacology, business.industry, Gallbladder, Middle Aged, Infectious Diseases, medicine.anatomical_structure, Endocrinology, Biliary tract, Piperacillin/tazobactam, Drainage, Female, beta-Lactamase Inhibitors, business, Research Article, medicine.drug |
| الوصف: | Piperacillin-tazobactam concentrations in serum and bile were measured intraoperatively in 10 patients undergoing cholecystectomy (group 1) and 5 cholecystectomized patients provided with external bile duct drainage (group 2). Each patient received a single intravenous dose of piperacillin at 4 g plus tazobactam at 0.5 g over 30 min. Drug concentrations in both serum and bile were measured by high-performance liquid chromatography. In group 1 patients, serum and bile specimens and gallbladder wall fragments were collected at mean times of 70 and 83 min postinfusion, respectively. The mean concentrations of piperacillin and tazobactam were, respectively, 69.1 +/- 41.5 (standard deviation) and 9.9 +/- 5.1 microg/ml in serum, 630.4 microg/ml (range, 24.8 to 1,194 microg/ml) and 11.8 microg/ml (range, 3.6 to 22 microg/ml) in choledochal bile, 342.3 microg/ml (range, 1.1 to 1,149 microg/ml) and 7.7 microg/ml, (range, 0.2 to 23.1 microg/ml) in gallbladder bile, and 49.3 microg/g (range, 9.7 to 223 microg/g) and 2.9 microg/g (range, 0.1 to 5.9 microg/g) in the gallbladder wall. In group 2 patients, the amounts of drugs recovered in bile drainage obtained over 12 h were 28.4 +/- 18.0 and 1.0 +/- 0.5 mg for piperacillin and tazobactam, respectively. Peak piperacillin and tazobactam concentrations in bile reached 358 +/- 242 and 10.8 +/- 4.2 microg/ml, respectively. Comparison of drug levels in serum and bile suggests an underlying active secretion process for piperacillin elimination into the bile, unlike that of tazobactam. From a therapeutic viewpoint, given the concentrations of tazobactam recorded in bile fluid and tissue, the addition of this beta-lactamase inhibitor to piperacillin therapy might be of interest in the management of biliary tract infections, mostly in patients at risk of mixed aerobic-anaerobic infections due to beta-lactamase-producing organisms. |
| تدمد: | 1098-6596 0066-4804 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::16a00e71edf58a51f8e0779cf880304e https://doi.org/10.1128/aac.41.8.1636 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....16a00e71edf58a51f8e0779cf880304e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10986596 00664804 |
|---|