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. 1996 Nov;40(11):2658–2660. doi: 10.1128/aac.40.11.2658

Biliary excretion of ciprofloxacin and piperacillin in the obstructed biliary tract.

S J van den Hazel 1, X H de Vries 1, P Speelman 1, J Dankert 1, G N Tytgat 1, K Huibregtse 1, D J van Leeuwen 1
PMCID: PMC163596  PMID: 8913485

Abstract

Biliary excretion of ciprofloxacin and piperacillin was determined in cholestatic patients who had undergone endoscopic cholangiography. The median concentration of ciprofloxacin (n = 9) was 2.36 micrograms/ml (range, 0.29 to 19.8 micrograms/ml) in bile compared with 1.66 micrograms/ml (range, 0.73 to 2.69 micrograms/ml) in serum. The median concentration of piperacillin (n = 7) was < 5 micrograms/ml (range, < 5 to 26) in bile compared with 14.3 micrograms/ml (range, 5.3 to 80) in serum. Ciprofloxacin, but not piperacillin, can be actively excreted into bile in the presence of a biliary tract obstruction.

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Selected References

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  1. Ball C. S., Manson J. M., Reid F., Tweedle D. E. The pharmacokinetics of the biliary excretion of ciprofloxacin. HPB Surg. 1989 Nov;1(4):319–327. doi: 10.1155/1989/41415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bergan T., Thorsteinsson S. B., Solberg R., Bjornskau L., Kolstad I. M., Johnsen S. Pharmacokinetics of ciprofloxacin: intravenous and increasing oral doses. Am J Med. 1987 Apr 27;82(4A):97–102. [PubMed] [Google Scholar]
  3. Blenkharn J. I., Habib N., Mok D., John L., McPherson G. A., Gibson R. N., Blumgart L. H., Benjamin I. S. Decreased biliary excretion of piperacillin after percutaneous relief of extrahepatic obstructive jaundice. Antimicrob Agents Chemother. 1985 Dec;28(6):778–780. doi: 10.1128/aac.28.6.778. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Calhoun P., Brown K. B., Strunk R., Krusch D. A., Scheld W. M., Hanks J. B. Experimental studies of biliary excretion of piperacillin. Ann Surg. 1987 Apr;205(4):420–427. doi: 10.1097/00000658-198704000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cao C. X., Silverstein S. C., Neu H. C., Steinberg T. H. J774 macrophages secrete antibiotics via organic anion transporters. J Infect Dis. 1992 Feb;165(2):322–328. doi: 10.1093/infdis/165.2.322. [DOI] [PubMed] [Google Scholar]
  6. Dan M., Verbin N., Gorea A., Nagar H., Berger S. A. Concentrations of ciprofloxacin in human liver, gallbladder, and bile after oral administration. Eur J Clin Pharmacol. 1987;32(2):217–218. doi: 10.1007/BF00542200. [DOI] [PubMed] [Google Scholar]
  7. Griffiths N. M., Hirst B. H., Simmons N. L. Active intestinal secretion of the fluoroquinolone antibacterials ciprofloxacin, norfloxacin and pefloxacin; a common secretory pathway? J Pharmacol Exp Ther. 1994 May;269(2):496–502. [PubMed] [Google Scholar]
  8. Griffiths N. M., Hirst B. H., Simmons N. L. Active secretion of the fluoroquinolone ciprofloxacin by human intestinal epithelial Caco-2 cell layers. Br J Pharmacol. 1993 Mar;108(3):575–576. doi: 10.1111/j.1476-5381.1993.tb12844.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Krol G. J., Beck G. W., Benham T. HPLC analysis of ciprofloxacin and ciprofloxacin metabolites in body fluids. J Pharm Biomed Anal. 1995 Dec;14(1-2):181–190. doi: 10.1016/0731-7085(95)01611-2. [DOI] [PubMed] [Google Scholar]
  10. Leung J. W., Chan R. C., Cheung S. W., Sung J. Y., Chung S. C., French G. L. The effect of obstruction on the biliary excretion of cefoperazone and ceftazidime. J Antimicrob Chemother. 1990 Mar;25(3):399–406. doi: 10.1093/jac/25.3.399. [DOI] [PubMed] [Google Scholar]
  11. Leung J. W., Ling T. K., Chan R. C., Cheung S. W., Lai C. W., Sung J. J., Chung S. C., Cheng A. F. Antibiotics, biliary sepsis, and bile duct stones. Gastrointest Endosc. 1994 Nov-Dec;40(6):716–721. [PubMed] [Google Scholar]
  12. Levi J. U., Martinez O. V., Malinin T. I., Zeppa R., Livingstone A., Hutson D., Calhoun P. Decreased biliary excretion of cefamandole after percutaneous biliary decompression in patients with total common bile duct obstruction. Antimicrob Agents Chemother. 1984 Dec;26(6):944–946. doi: 10.1128/aac.26.6.944. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Martinez O. V., Levi J. U., Devlin R. G. Biliary excretion of aztreonam in patients with biliary tract disease. Antimicrob Agents Chemother. 1984 Mar;25(3):358–361. doi: 10.1128/aac.25.3.358. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Morran C., McArdle C., Pettitt L., Sleigh D., Gemmell C., Hichens M., Felmingham D., Tillotson G. Pharmacokinetics of orally administered ciprofloxacin in abdominal surgery. Am J Med. 1989 Nov 30;87(5A):86S–88S. doi: 10.1016/0002-9343(89)90030-2. [DOI] [PubMed] [Google Scholar]
  15. Morris D. L., Mojaddedi Z. J., Burdon D. W., Keighley M. R. Clinical and microbiological evaluation of piperacillin in elective biliary surgery. J Hosp Infect. 1983 Jun;4(2):159–164. doi: 10.1016/0195-6701(83)90045-2. [DOI] [PubMed] [Google Scholar]
  16. Oude Elferink R. P., Jansen P. L. The role of the canalicular multispecific organic anion transporter in the disposal of endo- and xenobiotics. Pharmacol Ther. 1994 Oct;64(1):77–97. doi: 10.1016/0163-7258(94)90034-5. [DOI] [PubMed] [Google Scholar]
  17. Parry M. F., Smego D. A., Digiovanni M. A. Hepatobiliary kinetics and excretion of ciprofloxacin. Antimicrob Agents Chemother. 1988 Jul;32(7):982–985. doi: 10.1128/aac.32.7.982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Rubinstein E., St Julien L., Ramon J., Dautrey S., Farinotti R., Huneau J. F., Carbon C. The intestinal elimination of ciprofloxacin in the rat. J Infect Dis. 1994 Jan;169(1):218–221. doi: 10.1093/infdis/169.1.218. [DOI] [PubMed] [Google Scholar]
  19. Russo J., Jr, Thompson M. I., Russo M. E., Saxon B. A., Matsen J. M., Moody F. G., Rikkers L. F. Piperacillin distribution into bile, gallbladder wall, abdominal skeletal muscle, and adipose tissue in surgical patients. Antimicrob Agents Chemother. 1982 Sep;22(3):488–492. doi: 10.1128/aac.22.3.488. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Sörgel F., Naber K. G., Jaehde U., Reiter A., Seelmann R., Sigl G. Gastrointestinal secretion of ciprofloxacin. Evaluation of the charcoal model for investigations in healthy volunteers. Am J Med. 1989 Nov 30;87(5A):62S–65S. doi: 10.1016/0002-9343(89)90025-9. [DOI] [PubMed] [Google Scholar]
  21. Tanimura H., Tominaga S., Rai F., Matsumoto H. Transfer of ciprofloxacin to bile and determination of biliary metabolites in humans. Arzneimittelforschung. 1986 Sep;36(9):1417–1420. [PubMed] [Google Scholar]
  22. Taylor E. W., Poxon V., Alexander-Williams J., Jackson D. Biliary excretion of piperacillin. J Int Med Res. 1983;11(1):28–31. doi: 10.1177/030006058301100106. [DOI] [PubMed] [Google Scholar]
  23. Van Delden O. M., Van Leeuwen D. J., Jansen P. L., Hoek F. J., Huibregtse K., Tytgat G. N. Biliary excretion of ceftriaxone into non-stagnant and stagnant bile. J Antimicrob Chemother. 1994 Jan;33(1):193–194. doi: 10.1093/jac/33.1.193. [DOI] [PubMed] [Google Scholar]

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