Antibiotics

in the treatment of biliary infection Bile is difficult to obtain for culture in man. Because of this, antibiotic treatment of biliary infection is often directed towards biliary organisms which are suspected, rather than proven. To complicate effective treatment further, infection may be asymptomatic, presenting with septic complications following a surgical or radiological procedure. Despite knowledge of the pattern of infection in biliary disease, the microorganisms involved, and the spectrum and pharmacokinetics of potentially effective antibiotics, bacteria are often difficult to eradicate from the bile and biliary surgery has a high incidence of septic complications. There have been few reviews of this subject, particularly incorporating recent data, and a reassessment is necessary. This paper describes the clinical and bacteriological aspects of biliary infection, and the excretion and efficacy of specific antibiotics in bile. Based on th