The biliary tract excretion of three cephalosporins, cefazolin, cephaloridine, and cephalothin, was compared in patients with biliary tract disease. In the absence of obstruction, mean antibiotic levels in bile from gall bladder and common duct in patients undergoing cholecystectomy were highest for cefazolin (17 and 31 gg/ml, respectively) than either cephaloridine (7 and 9 gg/ml) or cephalothin (1 and 4 ug/ml). Biliary tract levels generally paralleled serum levels. In no patient with cystic duct obstruction were any of the cephalosporins detectable in appreciable amounts in gall bladder bile. In patients with T-tube drainage given each of the three different cephalosporins on separate days, concentrations of cefazolin in bile were many-fold higher than either cephaloridine or cephalothin. Peak levels of cefazolin in T-tube bile averaged 51 ;Ig/ml after intravenous and 26 ,g/ml after intramuscular administration, whereas mean peak levels of cephalothin and cephaloridine were only 6 and 16,ug/ml, respectively. Here, too, T-tube levels reflected serum concentrations and obstruction to biliary flow impaired excretion of each of the drugs.The correct choice of an antimicrobial drug for the therapy of suppurative biliary tract disease depends in a general sense upon two factors: the antimicrobial susceptibility pattern of the etiological agent, and the likelihood that the chosen antimicrobial will reach the site of the infection.

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The Consensus on Health Assistance for Smoking Cessation in Spain, is a document reviewing the treatment evidence, as well as policy needs in relation to smoking cessation in Spain. It has been developed by technical representatives of public health administrations, at a national and autonomous level, together with representatives of the scientific societies and professional bodies which are members of the Spanish coalition on smoking prevention National Committee on Tobacco Prevention (CNPT). After approval of a new national tobacco control law 28/2005, several tobacco control policies are being developed, especially by the autonomous governments, including treatment policies. Within this framework, and as part of the requirements of the law, all parties have considered the need to review effectiveness, experimentally validated tobacco dependence treatments and practices. An initial draft written by an expert committee was presented to all parties and discussed at three meetings over a period of a year and a half. The initial draft did review primary and secondary scientific literature from 1987 to 2007 on efficacy and effectiveness of different smoking cessation interventions, including: medical advice and brief smoking cessation interventions; pharmacological aids for treating nicotine dependence; behavioral interventions; specialized intensive treatment; community interventions; and treatment for groups with special needs. Considering the available evidence; current treatment needs; policy gaps; and the criteria of risk, accessibility, efficiency, sustainability and equity; the consensus document recommends the minimal requirements which should be taken into account when developing a policy on smoking cessation in Spain.