Klebsiella pneumoniae O3 lipopolysaccharide (LPS) has been found to dramatically modify the pharmacokinetics of the -lactam antibiotic cefazolin in rats. This study investigated the effect of LPS on the biliary excretion of the -lactam antibiotic cefoperazone (CPZ) in rats. CPZ is known to be actively secreted into the bile by a carrier-mediated transport system. LPS (250 g/kg of body weight) was infused for 20 to 30 min 2 h before an intravenous administration of CPZ (20 mg/kg). The pharmacokinetic parameters of CPZ were estimated by a noncompartment model. LPS induced a significant decrease in the systemic clearance (by approximately 50%) and an increase in the mean residence time of CPZ. Significant decreases were also seen in the bile flow rate and in the biliary recovery of unchanged CPZ in the LPS-treated rats. LPS tended to increase the proportion of urinary excretion of CPZ. LPS significantly decreased the biliary clearance (by approximately 55%) and renal clearance (by approximately 35%) of CPZ. However, no changes in the volume of distribution at steady state for CPZ were observed between the treatment groups. Our findings suggest that LPS induces changes in the pharmacokinetics of CPZ as a result of changes occurring in the biliary secretory system. Lipopolysaccharide (LPS), which is an active component in the outer membrane of gram-negative bacteria, is known for its various biological and immunological activities. LPS has been found to induce various changes in the body: circulatory changes, disseminated intravascular coagulation, and damage to numerous organs such as the central nervous system, liver, kidneys, heart, gastrointestinal tract, and lungs (8).A number of studies have discussed the effects of LPS on the liver (1, 9, 10, 13, 20, 31), which is known to be vital in clearing circulatory LPS in rats (3,37). Several investigators have also demonstrated that LPS is rapidly taken into the liver and localized in both the hepatocytes and Kupffer cells (2,22,23,33). LPS has been reported to have a cholestatic effect by decreasing the bile flow (29) and decreasing the biliary clearance (CL BILE ) of some organic anionic dyes such as sulfobromophthalein (BSP) and indocyanine green in isolated perfused rat livers (29,30). From these findings, it is thought that the transport system of some organic anionic drugs, which are mostly excreted into the bile, may be affected by LPS-induced changes in the hepatofunctions and liver excretory system. Several investigators have examined the effects of hyperbilirubinemia and diabetes on the hepatofunctions and biliary excretion of certain organic anionic antibiotics (17,18,24,35,36). However, there is little data available regarding the effect of LPS on hepatic transport and the biliary secretion of drugs.A series of experiments was designed in our laboratories to establish a guideline for the safe use of antibiotics which are excreted mainly into the bile. Studies were intended to benefit patients with hepatobiliary infections by gram-negative bacteria. This s...