[Acute and chronic biliary tract infections. Studies of the therapeutic effect of a new broad-spectrum cephalosporin]

Abstract

Diseases of the biliary tract are common problems, frequently encountered in clinical practice. Infection is a major cause of mortality in patients with extrahepatic obstruction, especially in the elderly patient. Survival in patients with biliary tract stones, complicating cholecystitis and ascending cholangitis or abscess formation depends on timing of surgery with decompression of the biliary tract, attention to fluid and electrolyte management and on prompt institution of antibiotics. The initial choice of antibiotics should be based on the organisms most frequently encountered in biliary tract sepsis, especially E. coli, enterococci, klebsiella, pseudomonas, clostridia and ps. aeruginosa. Serum levels as well as the concentration of the antibiotic in the bile are important factors determining efficacy. Cefoperazon (Cefobis), a new cephalosporin with a spectrum of antimicrobial activity that differs from some previously marketed cephalosporins, in that it is effective also against ps. aeruginosa, achieves high biliary concentrations. A clinical study is presented which proves this new antibiotic to be a safe drug and the cephalosporin of choice to treat biliary tract infections.