抗生物質(Ceftizoxime)の胆道系移行について EXCRETION OF CEFTIZOXIME IN BILE AND GALLBLADDER TISSUE

抗生物質の胆道系移行について,胆石手術症例61例をもちいて検討した.抗生物質としては, Ceftizoxime (CZX)を用いた.<br> 種々の病態における抗生物質の胆道系への移行を知る目的で,症例を術前に施行した排泄性胆嚢造影(DIC)陽性例と陰性例に,又,胆嚢組織の炎症程度によって分け,胆汁中及び胆嚢組織内抗生物質濃度の差を検討した.又,胆汁中細菌についても検討を加えた.<br> CZXは,胆嚢・胆管内胆汁及び胆嚢組織内へ良好な移行を示した.又,組織内濃度は炎症の程度による差はみられなかった.しかし排泄性胆嚢造影陰性例では陽性例に比し,胆汁中濃度は,その値にバラツキがみられ,低値を示すものがみられた.又菌検出率も30.8%と陽性例の12.0%に比し高率であった.

We measured the concentrations of the antibiotic Ceftizoxime (CZX) in the bile and gallbladder tissue and examined the prevalence of bacteria in the bile of 61 patients undergoing elective cholecystectomy.<br> The drug (2g) was given IV preoperatively. The results were as follows.<br> 1) CZX was well concentrated in the bile sampled from the gallbladder and the bile duct. CZX concentration of bile in the radiologically nonfunctioning gallbladder showed considerable variation and was lower compared with the functioning gallbladder.<br> 2) The values for CZX concentration of the tissue were high, and there was no correlation between the tissue concentration and degree of inflammation.<br> 3) Bacteria were isolated at operation from the bile in seven out of 38 patients (18.4%). There was a higher incidence of bile bacteria in the radiologically nonfunctioning gallbladder compared with the functioning gallbladder (30.8% and 12.8%, respectively).