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October 13, 1975

Questions and Answers

JAMA. 1975;234(2):204-205. doi:10.1001/jama.1975.03260150074029

Therapeutic-Drug Malabsorption Not Observed After Jejunoileal Bypass  Q A patient who had a jejunoileal bypass operation has not responded to treatment of otitis media with cephalexin monohydrate (Keflex), 500 mg four times a day (she is allergic to penicillin). An otolaryngologist cannot account for the failure of response to the antibiotic. Are there reports of therapeutic-drug malabsorption in patients after they have had a jejunoileal bypass operation?D. R. Webb, MD Beaumont, TexasA I know of no published data on the absorption of orally administered antibiotics after a jejunoileal bypass operation. We are currently embarking on a cooperative study of postoperative drug absorption; however, we are starting with the digitalis preparations. I would suggest that you administer to your patient cephalothin sodium (Keflin) intramuscularly. If the patient does not respond, then you and the otolaryngologist must seek an explanation for a failure of response elsewhere than in an absorptive