BILIARY ELIMINATION OF CIPROFLOXACIN IN MAN

  • 1 January 1985
    • journal article
    • research article
    • Vol. 115  (13) , 448-453
Abstract
To investigate the possibility of therapeutic use of ciprofloxacin in infections of the biliary tract, the serum and bile kinetics, and the biliary, urinary and fecal elimination of this new broad-spectrum quinolone were studied in 12 recently cholecystectomized patients with T-tube drainage. Ciprofloxacin concentrations were determined by simultaneously performed HPLC (high performance liquid chromatography) and microbiological assay in serum, urine, and bile over a 24-h period following oral administration of a single dose of 500 mg of the drug. The 2 methods yielded similar values both in the serum and in the urine. Average peak serum concentrations were 0.97 .+-. SE 0.17 .mu.g/ml (HPLC) and 1.08 .+-. 0.19 .mu.g/ml (microbiological assay) (NS [not significant]). The respective mean urinary concentrations in the first 6-h sample were 267 .+-. 74 .mu.g/ml and 241 .+-. 58 .mu.g/ml (NS). In bile, however, the microbiological assay gave higher values than HPLC: average peak concentrations of 10.3 .+-. 3.4 .mu.g/ml and 7.5 .+-. 2.8 .mu.g/ml (P < 0.02), respectively, reached during the 2nd h after drug administration, and mean total 24-h biliary ciprofloxacin output of 2167 .+-. 288 .mu.g and 1587 .+-. 222 .mu.g (P < 0.01), respectively. This may point to hepatic metabolite(s) than the parent compound. The significantly higher concentrations of ciprofloxacin in bile than in serum exceeded the minimum inhibitory concentration for organisms usually responsible for biliary infections. These infections may, therefore, be favorably affected by ciprofloxacin.

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