The Role of Antibiotics in Infections of the Biliary Tract Studies in Sensitivity and Biliary Tract Excretion*

Twiss, John Russell; Gillette, Lee; Berger, William V.; Aronson, Allan R.; Siegel, Louis

doi:10.1097/00000658-195612000-00009

Cited by 9 publications

(2 citation statements)

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“…, tetracycline and oxytetracycline (Pulaski and Fusillo, 1955;Zaslow, Cohn, and Ball, 1955;Twiss, Gillette, Berger, Aronson, and Siegel, 1956a;Lambrecht, 1958), tetracycline-l-methylenlisine (Tolio, 1961), and erythromycin (Twiss, Berger, Gillette, Aronson, and Siegel, 1956b). With this mode of collection of bile it is possible to obtain a single measure of the degree of excretion.…”

mentioning

confidence: 99%

“…The biliary drainage by T-tube or biliary fistula has been employed for studies on penicillin and streptomycin (Zaslow, Counseller, and Heilman, 1947b), tetracycline, and oxytetracycline (Herrel, Heilman, and Wellman, 1950;Danopoulos, Angelopoulos, Zioudrou, and Amira, 1954;Maynard, Prigot, and Andriola, 1954-55;Zaslow, Cohn, and Ball, 1954-55a and b;Twiss, Gillette, Berger, Aronson, and Siegel, 1956a;Uberti, 1956), chlortetracycline (Herrell and Heilman, 1949), demethylchlortetracycline (Kunin and Finland, 1959), chloramphenicol (Glazko, Wolf, Dill, and Bratton, 1949), erythromycin (Twiss et al, 1956b;Hammond and Griffith, 1961), rifamycin SV and rifamide (Fiuresz, Acocella, and Scotti, 1963;Lusena, Acocella, Baroni, and Santilli, 1963;Acocella, Lamarina, Tenconi, and Nicolis, 1966), novobiocin (Martin, Heilman, Nichols, Wellman, and Geraci, 1955), and kanamycin (Preston, Silverman, Henegar, and Neveril, 1959-60). The biliary drainage by T-tube may not allow an accurate quantitative evaluation of the recovery of the antibiotic excreted in bile owing to the incomplete external drainage of bile, although some authors maintain that the drainage of bile through a T-tube in man is virtually complete, provided that the vertical limb of the tube remains unobstructed (Rundle, Cass, Robson, and Middleton, 1955).…”

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Biliary excretion of antibiotics in man.

Acocella¹,

Mattiussi²,

Nicolis³

et al. 1968

Gut

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mentioning

confidence: 99%

mentioning

confidence: 99%

Biliary excretion of antibiotics in man.

Acocella¹,

Mattiussi²,

Nicolis³

et al. 1968

Gut

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A controlled trial of parenteral prophylactic gentamicin therapy in biliary surgery

Keighley

Baddeley

Burdon

et al. 1975

Journal of British Surgery

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This trial has investigated the value of gentamicin therapy in patients requiring biliary surgery. One hundred consecutive patients were randomly allocated to receive either gentamicin or no antibiotic. Post-operative infection was assessed by an independent observer. Cultures and gentamicin assays were performed on bile and blood sampled during and after operation. The minimum inhibitory concentrations of gentamicin were measured with isolated bacterial. In 80 per cent of patients biliary organisms were inhibited by 2 mug/ml of gentamicin. Twice this concentration was found in the serum at operation in 88 per cent, but in the bile in only 18 per cent. Nevertheless, gentamicin lowered the incidence of bacteria in the bile from 42 to 25 per cent. There was a reduction in wound sepsis from 21 to 6 per cent (P less than 0-05). Bacteriaemia was demonstrated in only 1 patient receiving gentamicin compared with 5 controls and 1 death occurred from endotoxaemia in the control group. These data suggest that gentamicin will reduce the morbidity of biliary surgery, particularly in patients in whom the bile is infected at operation.

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Multivariate analysis of clinical and operative findings associated with biliary sepsis

Keighley

Flinn

Alexander-Williams

1976

Journal of British Surgery

117

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A cluster analysis of 17 preoperative and 10 operative variables has been undertaken from a prospective study of 181 patients undergoing operations on the biliary tract in order to identify those with organisms in the bile who would therefore benefit from prophylactic antibiotic cover. The analysis defined populations of high risk (45 patients) and low risk (136 patients) in which the incidence of infected bile was 67 and 19 per cent respectively (P less than 0-001). Eight variables were more common in the high risk than in the low risk group (P less than 0-001). These "high risk factors" were: jaundice at operation, recent rigoors, emergency operation or one within 4 weeks of an emergency admission, age over 70 years, previous biliary operation, common duct obstruction and stones in the bile duct. In 67 patients where one or more "high risk factors" was present, the bile contained organisms in 37 (53 percent); when 4 "high risk factors" occurred in the same patient (16 cases) biliary organisms were isolated in 14(87 per cent). We conclude that the presence of one or more "high risk factors" indicates a patient in whom prophylactic antibiotics would be advised during an operation on the biliary tract.

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The Role of Antibiotics in Infections of the Biliary Tract Studies in Sensitivity and Biliary Tract Excretion*

Cited by 9 publications

References 1 publication

Biliary excretion of antibiotics in man.

Biliary excretion of antibiotics in man.

A controlled trial of parenteral prophylactic gentamicin therapy in biliary surgery

Multivariate analysis of clinical and operative findings associated with biliary sepsis

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