Bile levels of imipenem in patients with T-drain following the administration of imipenem/cilastatin.

Twenty-four patients undergoing gall bladder surgery and placement of a Kehr T-tube were examined for imipenem pharmacokinetics in plasma and bile fluid following an intravenous short-term infusion (20 min) of 500 mg respectively 1000 mg each of imipenem and cilastatin. In group I (500 mg; 12 patients) a mean peak concentration in bile fluid of 10.5 mg/l (range 1.5 to 16.7 mg/l) was reached just after 10 min. 60 min after the end of infusion the imipenem concentration was between 8 and 9 mg/l. In group I the half-life of imipenem in bile was 0.84 h. In group II (1000 mg; 12 patients) the mean peak level in bile fluid was 17.5 mg/l (range 3.5 to 51.3 mg/l). The half-life in bile was 1.24 h in this group. The data indicated that 4 h after the administration of either 1000 mg or 500 mg, imipenem serum and bile concentrations were markedly above the MIC values for pathogens expected to be found in infections of the biliary tract.