Excretion of Clindamycin in the Bile of Patients with Biliary Tract Disease

Sales, J. E. L.; Sutcliffe, Marion; O'Grady, F.

doi:10.1159/000221434

Cited by 12 publications

(7 citation statements)

References 3 publications

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“…Both appear to be extensively eliminated by hepatic mechanisms [121]. The penetration of lincomycin in cho-ledochal bile, cholecystic bile, gallbladder tissue and liver tissue was found to be good.…”

Section: Lincozamidesmentioning

confidence: 95%

“…After intravenous doses of 600 mg of clindamycin every 6 h in 2 patients, mean levels of 33.9 Ìg/ml in gallbladder bile and 41.1 Ìg/ml in common bile duct were found. Sales et al [121] found a mean bile duct level of 26.2 and 41.3 Ìg/ml in gallbladder bile.…”

Section: Lincozamidesmentioning

confidence: 96%

“…Clindamycin is partially metabolized in liver. However, the resultant biliary tract excretion product is more active than the parent compound [121]. After intravenous doses of 600 mg of clindamycin every 6 h in 2 patients, mean levels of 33.9 Ìg/ml in gallbladder bile and 41.1 Ìg/ml in common bile duct were found.…”

Section: Lincozamidesmentioning

confidence: 96%

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Biliary Excretion of Antimicrobial Drugs

Karachalios

Charalabopoulos²

2002

Chemotherapy

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The development of drugs able to prevent and cure bacterial infections is one of the 20th century’s major contributions to human longevity and quality of life. Antibacterial agents are among the most commonly prescribed drugs of any kind worldwide. Used appropriately, these drugs are lifesaving. To eliminate an infection as rapidly as possible, a sufficient concentration of the drug(s) chosen must reach the site of infection. Serum/tissue concentration is a result of various parameters such as absorption, excretion, protein binding and metabolic inactivation. Biliary excretion is an important route for the elimination of some drugs and drug metabolites in humans. Thus, drugs with a high bile concentration are indicated for the treatment of gallbladder infectious diseases. We present a review of a large number of antimicrobial agents most commonly used in daily clinical practice, with regard to their biliary excretion.

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Section: Lincozamidesmentioning

confidence: 95%

Section: Lincozamidesmentioning

confidence: 96%

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Biliary Excretion of Antimicrobial Drugs

Karachalios

Charalabopoulos²

2002

Chemotherapy

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“…When biliary obstruction is present, even an antimicrobial drug with excellent biliary excretion may not enter the bile tract (level 3b–4) . The active transfer of antimicrobial drugs into bile is not restored early after the biliary obstruction has been relieved (level 4) ,. Therefore, immediate biliary drainage, as well as the administration of antimicrobials, is crucial in view of controlling the source of infection.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial therapy for acute cholangitis: Tokyo Guidelines

Yoshida

Takada

Kawarada

et al. 2007

J Hepatobiliary Pancreat Surg

124

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Antimicrobial agents should be administered to all patients with suspected acute cholangitis as a priority as soon as possible. Bile cultures should be performed at the earliest opportunity. The important factors which should be considered in selecting antimicrobial therapy include the agent’s activity against potentially infecting bacteria, the severity of the cholangitis, the presence or absence of renal and hepatic diseases, the patient’s recent history of antimicrobial therapy, and any recent culture results, if available. Biliary penetration of the microbial agents should also be considered in the selection of antimicrobials, but activity against the infecting isolates is of greatest importance. If the causative organisms are identified, empirically chosen antimicrobial drugs should be replaced by narrower-spectrum antimicrobial agents, the most appropriate for the species and the site of the infection.

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“…However, there are no clinical or experimental data to support this. For reference, Table 2 shows antimicrobial agents with good penetration of the gallbladder wall (level 3b–4) …”

Section: Introductionmentioning

confidence: 99%

Antimicrobial therapy for acute cholecystitis: Tokyo Guidelines

Yoshida

Takada

Kawarada

et al. 2007

J Hepatobiliary Pancreat Surg

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Acute cholecystitis consists of various morbid conditions, ranging from mild cases that are relieved by the oral administration of antimicrobial drugs or that resolve even without antimicrobials to severe cases complicated by biliary peritonitis. Microbial cultures should be performed by collecting bile at all available opportunities to identify both aerobic and anaerobic organisms. Empirically selected antimicrobials should be administered. Antimicrobial activity against potential causative organisms, the severity of the cholecystitis, the patient’s past history of antimicrobial therapy, and local susceptibility patterns (antibiogram) must be taken into consideration in the choice of antimicrobial drugs. In mild cases which closely mimic biliary colic, the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) is recommended to prevent the progression of inflammation (recommendation grade A). When causative organisms are identified, the antimicrobial drug should be changed for a narrower-spectrum antimicrobial agent on the basis of the species and their susceptibility testing results.

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Excretion of Clindamycin in the Bile of Patients with Biliary Tract Disease

Cited by 12 publications

References 3 publications

Biliary Excretion of Antimicrobial Drugs

Biliary Excretion of Antimicrobial Drugs

Antimicrobial therapy for acute cholangitis: Tokyo Guidelines

Antimicrobial therapy for acute cholecystitis: Tokyo Guidelines

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