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Forty-five patients with varying biliary pathology were injected with one gram of intramuscular cefazolin sodium prior to surgery. Serum, gallbladder bile, and common duct bile levels were measured. The type of biliary disease did not influence serum levels (mean, 29 μg per milliliter) which reached a peak one hour after injection. Mean common duct bile levels were reduced from 52 μg per milliliter in nonjaundiced patients to 4 μg per milliliter in those with jaundice (p < 0.001). Patients with radiologically functioning gallbladders had significantly higher mean gallbladder bile levels (21 μg per milliliter; p < 0.005). Surprisingly, the mean gallbladder bile level in acute cholecystitis was 25 μg per milliliter. As the minimum inhibitory concentration of cefazolin for organisms commonly found in the bile is 0.5 to 6 μg per milliliter, we suggest that cefazolin sodium may be of value in the treatment of biliary disease, particularly acute cholecystitis.
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Accepted: June 1, 1976
☆Supported in part by a Wellcome Trust Research Fellowship.
© 1977 Published by Elsevier Inc.