The excretion of cefuroxime in human bile

Thomas, M. Lea; Dash, C. H.; Burnand, K. G.; Woodyer, Anthony

doi:10.1002/bjs.1800680421

Cited by 12 publications

(7 citation statements)

References 7 publications

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“…Unfortunately, there are conflicting data on the efficacy of aminopenicillins and oral cephalosporins. Although studies support the use of cefuroxime (with metronidazole) given their excellent excretion into the biliary tract [ 24 ], we frequently cultured enterococci and unsusceptible Gram negative rods in our cultures, which is supported by other studies [ 8 ]. Therefore, cefuroxim can only be recommended in mild cases and based on local susceptibility rates which can be discussed with the local antibiotic stewardship team.…”

Section: Discussionsupporting

confidence: 73%

Clinical Presentation and Incidence of Anaerobic Bacteria in Surgically Treated Biliary Tract Infections and Cholecystitis

et al. 2021

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(1) Background: Cholecystitis and cholangitis are among the most common diseases treated by general surgery. Gallstones lead to inflammation and bacterial infection of the biliary tract. Biliary infections can lead to live threatening bacteremia and liver abscesses. The true role of anaerobes remains unclear. (2) Methods: We retrospectively analyzed bacterial cultures from biliary samples obtained from bile ducts and gallbladders at our tertiary care center. Patient characteristics and clinical outcomes were analyzed. (3) Results: In our database of 1719 patients, 365 patients had microbial testing, of which 42 grew anaerobic bacteria. Anaerobes were more frequently cultured in patients with hepatic abscesses and gallbladder perforation. These patients were older and had more comorbidities than the control group. The overall outcomes of all patients were favorable and the resistance rate to commonly used antibiotics remained low. (4) Conclusions: Anaerobes in biliary tract infections appear to be underdiagnosed and more prevalent in the elderly with advanced disease. Due to low antibiotic resistance, the combination of source control and adjunct anti-infective treatment leads to favorable outcomes.

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Section: Discussionsupporting

confidence: 73%

Clinical Presentation and Incidence of Anaerobic Bacteria in Surgically Treated Biliary Tract Infections and Cholecystitis

et al. 2021

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“…1981 73 5.4 [G]/42.8 [BD]1500 mgivThomas et al . 1981 74 4.8 [G]/9.0 [BD]750 mgivSevern and Powis 1979 75 Cefpodoxime proxetil2.0–3.62080—no data available———Cefixime3.0–4.065501056.9 ± 70.9 [T]200 mgoralWestphal et al . 1993 76 199.3 (8.8–1163.8)200 mg twice daily (×4)oralMoorthi et al .…”

Section: Are All Cephalosporins the Same With Regard To CDI Risk?mentioning

confidence: 99%

Role of cephalosporins in the era ofClostridium difficileinfection

Wilcox

Chalmers

Nord

et al. 2016

J. Antimicrob. Chemother.

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The incidence of Clostridium difficile infection (CDI) in Europe has increased markedly since 2000. Previous meta-analyses have suggested a strong association between cephalosporin use and CDI, and many national programmes on CDI control have focused on reducing cephalosporin usage. Despite reductions in cephalosporin use, however, rates of CDI have continued to rise. This review examines the potential association of CDI with cephalosporins, and considers other factors that influence CDI risk. EUCLID (the EUropean, multicentre, prospective biannual point prevalence study of CLostridium difficile Infection in hospitalized patients with Diarrhoea) reported an increase in the annual incidence of CDI from 6.6 to 7.3 cases per 10 000 patient bed-days from 2011–12 to 2012–13, respectively. While CDI incidence and cephalosporin usage varied widely across countries studied, there was no clear association between overall cephalosporin prescribing (or the use of any particular cephalosporin) and CDI incidence. Moreover, variations in the pharmacokinetic and pharmacodynamic properties of cephalosporins of the same generation make categorization by generation insufficient for predicting impact on gut microbiota. A multitude of additional factors can affect the risk of CDI. Antibiotic choice is an important consideration; however, CDI risk is associated with a range of antibiotic classes. Prescription of multiple antibiotics and a long duration of treatment are key risk factors for CDI, and risk also differs across patient populations. We propose that all of these are factors that should be taken into account when selecting an antibiotic, rather than focusing on the exclusion of individual drug classes.

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“…However, this result has been controversial because another report showed that the interaction occurred in bile duct-cannulated rats (Yamamura et al, 1999). In addition, the biliary concentrations of carbapenems in human are less than those of other ␤-lactam antibiotics, which have been reported not to interact with VPA (Thomas et al, 1981;Shiramatsu et al, 1988;Morimoto et al, 1991;Granai et al, 1992;De Turck et al, 1998;Yamagata et al, 1998), supporting the fact that the interaction at the enterohepatic circulation process would be improbable in humans. As to the blood cell distribution process, Omoda et al (2005) reported that the blood levels of VPA were not changed when the plasma level was decreased after intravenous administration of VPA with carbapenems in rats.…”

Section: Discussionmentioning

confidence: 98%

Identification of Valproic Acid Glucuronide Hydrolase As a Key Enzyme for the Interaction of Valproic Acid with Carbapenem Antibiotics

Suzuki¹,

Yamamura²,

Ogura³

et al. 2010

Drug Metab Dispos

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ABSTRACT:Plasma levels of valproic acid (VPA) are decreased by concomitant use with carbapenem antibiotics, such as panipenem (PAPM). One of the plausible mechanisms of this interaction is the inhibition of VPA glucuronide (VPA-G) hydrolysis by carbapenems in the liver. To elucidate this interaction mechanism, we purified VPA-G hydrolase from human liver cytosol, in which the hydrolytic activity was mainly located. After chromatographic purification, the VPA-G hydrolase was identified as acylpeptide hydrolase (APEH). APEHdepleted cytosol, prepared by an immunodepletion method, completely lacked the hydrolytic activity. These results demonstrate that APEH is a single enzyme involved in PAPM-sensitive VPA-G hydrolysis in cytosol. In addition, the hydrolytic activity of recombinant human APEH was inhibited by PAPM and the inhibition profile by typical esterase inhibitors (diisopropyl fluorophosphate, 5,5-dithiobis(2-nitrobenzoic acid), p-chloromercuribenzoic acid, and D-saccharic acid 1,4-lactone) was similar to that of human liver cytosol. Cytosolic VPA-G hydrolase activity was slightly inhibited by cholinesterase and carboxylesterase inhibitors. ␤-Glucuronidase activity remained in APEH-depleted cytosol, whereas VPA-G hydrolase activity was completely abolished. Thus, either cholinesterase, carboxylesterase, or ␤-glucuronidase in cytosol would not be involved in VPA-G hydrolysis. Taken together, APEH plays a major role in the PAPM-sensitive VPA-G hydrolysis in the liver. These findings suggest that APEH could be a key enzyme for the drug interaction of VPA with carbapenems via VPA-G hydrolysis.

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The excretion of cefuroxime in human bile

Cited by 12 publications

References 7 publications

Clinical Presentation and Incidence of Anaerobic Bacteria in Surgically Treated Biliary Tract Infections and Cholecystitis

Clinical Presentation and Incidence of Anaerobic Bacteria in Surgically Treated Biliary Tract Infections and Cholecystitis

Role of cephalosporins in the era ofClostridium difficileinfection

Identification of Valproic Acid Glucuronide Hydrolase As a Key Enzyme for the Interaction of Valproic Acid with Carbapenem Antibiotics

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