The effect of cefmetazole, a broad-spectrum cephalosporin, on bile flow and composition in rats was studied. Intravenous injection of cefmetazole at doses ranging from 40 to 400 ,umol/kg of body weight led to an increase in its biliary concentration and excretion rate, with a maximum at 30 min after injection. Excretion of cefmetazole into bile was associated with a marked choleresis. The magnitude of the increase in bile flow was dose dependent, with a maximal increase at a dose of 200 ,umol/kg. Cefmetazole administration did not affect the secretion of bile acids or their osmotic activities, whereas the bile acid-independent bile flow increased by 49% at a dose of 200 ,umol/kg. Cefmetazole administration at a dose of 200 timol/kg significantly increased the biliary outputs of sodium, potassium, chloride, and bicarbonate (+36, +56, +28, and +31%, respectively) compared with outputs of controls. A linear relationship was observed between bile flow and cefmetazole excretion, 44 pil of bile being produced per ,umol of cefmetazole excreted into bile. Our results demonstrate that cefmetazole induces choleresis by stimulating bile acid-independent bile flow. This effect appears to be partly due to the osmotic properties of cefmetazole transported into bile.Cefmetazole sodium [7-,-cyanomethylthioacetamide-7-amethoxy -is a semisynthetic derivative of cephamycin. This cephalosporin has a broad antimicrobial spectrum, is efficient against gram-positive and gram-negative bacteria, and shows high resistance to attack by different P-lactamases (23,31). Several studies have confirmed its usefulness in the treatment of different kinds of infections and in prophylactic administration after surgical wounds (11). Since the drug was first released for clinical use, its pharmacokinetics and metabolism in humans and different animals have been described elsewhere (23,25,26). The antibiotic is excreted via urine and bile, with significant species differences in the participation of both routes (18,26,27). The biliary excretion of cefmetazole has been shown to be closely related to the bile/plasma ratio of bile acids (27) and dependent on the amount of bile flow and liver function (26).Appropriate antibiotic therapy in treatment of biliary tract infections must take into account the transfer of the drug into bile. The purpose of this study was to examine the effects of biliary elimination of cefmetazole on the formation of bile in rats. The influences of cefmetazole on the bile acid-dependent and -independent components of bile flow and on bile composition were evaluated. [vol/vol]); flow rate, 1.0 ml/min. The detection limit was 0.1 ,ug of cefmetazole per ml; the variation coefficient varied between 3.7 and 4.2% of the high and low concentrations assayed, respectively (12, 23).The possible existence of a correlation between the variables studied was investigated by linear regression analysis,