Brogard J M, Audhuy B, Pinget M, Dorner M
Ann Med Interne (Paris). 1984;135(7):512-8.
The present study is devoted to the biliary excretion of some beta-lactam antibiotics (6 derived from the penicillin group: Penicillin G, Ampicillin, Metampicillin, Carbenicillin, Mezlocillin, Apalcillin and 9 from the cephalosporin group: Cephalothin, Cephaloridine, Cephacetrile, Cefalexin, Cefazolin, Cefamandole, Cefuroxime, Cefaclor and Ceftizoxime). The biliary excretion of these antibiotics was assessed by 4 different procedures: 1) experimental study of their biliary elimination by a perfused isolated rabbit liver; 2) in humans, by evaluation of their passage: a) in aspirated duodenal fluid, b) in bile collected by external biliary drainage, c) and in bile obtained by puncture of the main bile duct and the gall bladder during surgery. The results of these different investigations were concordant and showed that the biliary excretion of Metampicillin, Apalcillin and Mezlocillin was definitely higher than that of the other studied beta-lactams; on account of their suitable antibacterial spectrum, these 3 derivatives should be used in preference for the treatment of biliary infection.
本研究致力于某些β-内酰胺类抗生素的胆汁排泄情况（6种源自青霉素类：青霉素G、氨苄西林、甲氧西林、羧苄西林、美洛西林、阿帕西林；9种源自头孢菌素类：头孢噻吩、头孢噻啶、头孢乙腈、头孢氨苄、头孢唑林、头孢孟多、头孢呋辛、头孢克洛和头孢唑肟）。通过4种不同方法评估这些抗生素的胆汁排泄情况：1）通过灌注离体兔肝对其胆汁清除进行实验研究；2）在人体中，通过评估其在以下方面的排泄情况：a）抽吸的十二指肠液中；b）经体外胆汁引流收集的胆汁中；c）手术期间通过穿刺胆总管和胆囊获得的胆汁中。这些不同研究的结果一致，表明甲氧西林、阿帕西林和美洛西林的胆汁排泄明显高于其他所研究的β-内酰胺类药物；鉴于它们具有合适的抗菌谱，这3种衍生物应优先用于治疗胆道感染。
