Estimation of the biliary excretion of different cephalosporins utilizing retrograde cholangio-pancreatography (ERCP).

In the present study 21 patients undergoing retrograde cholangio-pancreatography (ERCP) were given cefamandole, cefazolin or cefaclor, and plasma and bile concentrations were measured. The cannulation of the common bile duct was possible in most of the patients investigated, but no bile could be obtained in 7 of them. In the patients in whom bile was obtained, concentrations comparable to other studies were estimated, despite a wide variation in the individual patients. In addition, cefaclor, which is not known to be excreted in the bile, showed sufficiently high inhibitory bile concentrations. Using ERCP for the estimation of bile concentrations of different drugs useful information can be obtained about the excretion of certain substances. However, for sophisticated pharmacokinetic studies, the method has certain limitations as compared with classical T-tube sampling.