A study of the biliary excretion of mecillinam in patients with biliary disease

Hares, M. M.; Hegarty, Aisling; Tomkyns, Jennifer G.; Burdon, D. W.; Keighley, M. R. B.

doi:10.1093/jac/9.3.217

Cited by 10 publications

(3 citation statements)

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“…Biliary concentrations are sufficient to kill most isolates of E coli, Klebsiella spp and Proteus spp, but not of Strep faecalis. 26 Carbenicillin and ticarcillin have activity against Ps aeruginosa as well as the other biliary pathogens, but after 1 gram of carbenicillin the MIC for Ps aeruginosa is not always exceeded by the concentrations found in bile.17…”

Section: Penicillinsmentioning

confidence: 99%

Antibiotics in the treatment of biliary infection.

Dooley¹,

Hamilton-Miller²,

Brumfitt³

et al. 1984

Gut

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Section: Penicillinsmentioning

confidence: 99%

Antibiotics in the treatment of biliary infection.

Dooley¹,

Hamilton-Miller²,

Brumfitt³

et al. 1984

Gut

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“…Mecillinam is excreted mainly unchanged in urine. Biliary levels are higher that those in the serum provided that the biliary tract is not obstructed [34]. Mecillinam, when given orally, produces levels of 6.2 Ìg/ml within 2 h of a single dose of 400 mg [35].…”

Section: Other Penicillinsmentioning

confidence: 99%

“…Mecillinam, when given orally, produces levels of 6.2 Ìg/ml within 2 h of a single dose of 400 mg [35]. In another study levels of mecillinam were measured in serum and bile samples 1-3 h after the administration of 800 mg intramuscularly 1 h preoperatively in 53 patients undergoing biliary surgery, of whom 11 patients were jaundiced [36]. In the nonjaundiced group, the mean concentration of mecillinam in 26 patients with normal gallbladder function was 40 compared to 12 Ìg/ml in 16 patients with a nonfunctioning gallbladder.…”

Section: Other Penicillinsmentioning

confidence: 99%

Biliary Excretion of Antimicrobial Drugs

Karachalios

Charalabopoulos²

2002

Chemotherapy

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The development of drugs able to prevent and cure bacterial infections is one of the 20th century’s major contributions to human longevity and quality of life. Antibacterial agents are among the most commonly prescribed drugs of any kind worldwide. Used appropriately, these drugs are lifesaving. To eliminate an infection as rapidly as possible, a sufficient concentration of the drug(s) chosen must reach the site of infection. Serum/tissue concentration is a result of various parameters such as absorption, excretion, protein binding and metabolic inactivation. Biliary excretion is an important route for the elimination of some drugs and drug metabolites in humans. Thus, drugs with a high bile concentration are indicated for the treatment of gallbladder infectious diseases. We present a review of a large number of antimicrobial agents most commonly used in daily clinical practice, with regard to their biliary excretion.

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Amdinocillin: A Novel Penicillin; Antibacterial Activity, Pharmacology and Clinical Use

Neu

1985

Pharmacotherapy

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Amdinocillin is a novel penicillin whose antibacterial activity is derived from its ability to bind specifically and avidly to Penicillin Binding Protein-2 (PBP 2). Other beta-lactams bind almost exclusively to PBPs 1 and 3. This unique feature has prompted many investigators to predict that amdinocillin would aggressively synergize with other antimicrobials, particularly other beta-lactams. Certain features of these predictions have been realized. Amdinocillin is active alone against many gram-negative organisms. Pseudomonas and non-fermenting gram-negative bacteria, however, are usually resistant. Amdinocillin, in combination with many beta-lactams, exhibits marked synergy against many enterobacteriaceae. No such synergy can be demonstrated for gram-positive organisms or pseudomonas species. Amdinocillin is not beta-lactamase stable. Organisms which produce high levels of plasma-mediated beta-lactamase are resistant to the drug. Amdinocillin is widely distributed to most tissues of the body. It is removed by renal tubular secretion which results in prodigious levels of the drug in the urine. Co-administration of probenecid results in markedly elevated plasma levels of amdinocillin and delays its excretion. Amdinocillin has a plasma half-life of about one hour in patients with grossly normal renal function. Its half-life increases to 3 to 6 hours in anephric patients. The spectrum of adverse reactions observed with amdinocillin is similar to that of other penicillins. Amdinocillin, as a single agent, is effective in the treatment of urinary tract infections caused by susceptible strains of E. coli and klebsiella and enterobacter species. When amdinocillin is used in concert with other antimicrobials, synergy can frequently be demonstrated but it is essentially limited to gram-negative aerobic organisms. At present, insufficient data are available to precisely profile the utility of amdinocillin, either alone or in combination, in the treatment of systemic infections.

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A study of the biliary excretion of mecillinam in patients with biliary disease

Cited by 10 publications

References 0 publications

Antibiotics in the treatment of biliary infection.

Antibiotics in the treatment of biliary infection.

Biliary Excretion of Antimicrobial Drugs

Amdinocillin: A Novel Penicillin; Antibacterial Activity, Pharmacology and Clinical Use

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