Maternal-Fetal Transfer of Cefazolin

Abstract

To investigate the maternal-fetal transfer o f Cefazolin, (CEZ), a new a n t i b i o t i c , and i t s d i s t r i b u t i o n i n the fetus, a s i n g l e 14 mg/kg I.M. dose was administered t o 41 gravidas (18-1st trimester, 23-2nd trimester) % t o 684 hours p r i o r t o therapeutic abortion and s t e r i l i z a t i o n by hysterectomy. CEZ concentration was assayed microbiologically i n maternal serum, myometrium, placenta, f e t a l tissues (brain, lung, l i v e r and kidney) and f e t a l f l u i d s (amniotic, CSF, urine and serum). Maternal serum h a l f -l i f e o f CEZ was 2.2 hours w i t h a peak serum concentration o f 63 ug/ml a t To. H a l f -l i f e and maximum CEZ concentrations were 3.2 hours and 0.16 ug/ml f o r placenta, 3.9 hours and 7.5 ug/ml f o r cord blood, and 9.4 hours and 0.8 u g h 1 f o r amniotic f l u i d . CEZ was not detected i n f e t a l CSF, brain, kidney, lung o r l i v e r . CEZ was mini m a l l y 6 lug/ml) detected i n f e t a l u r i n e from 2 t o 12 hours.Only three myometrial samples between % and 1 3/4 hours had minimal CEZ concentrations. There were no differences i n CEZ concentrations noted i n any tissues o r f l u i d s w i t h increasi n g weeks' gestation.No accumulation o f CEZ was demonstrated i n the fetus. Fetal serum concentrations were 5 t o 10% o f the maternal serum and i n the MIC range o f susceptible organisms. N-9, N-11, N-13, and N-27 were m s t ccmron to CF patients. Types N-7 and N-11 w e found rmst frequently in those with severe i q x h w n t or -tion Between June, 1972 and March, 1973, an epidemic of idiopathic gastroenteritis affected 59 infants in the nursery of this hospital. Microbiological evidence obtained by prevalence surveys established an enterotoxigenic E. coli 0142/ K86/H6 as the etiology of the outbreak. Clinical illness frequently was severe, resulting in 4 deaths and in intractable diarrhea in an additional 17 babies. Attack rates were found to be highest for low-birth-weight infants during the first two weeks of life. No predisposition was found to be associated with prior antibiotic therapy, gavage feeding, oxygen therapy, or birth by Caesarian section. Environmental microbiologic data incriminates the hands of personnel as potential transmission vehicles; hand carriage of the epidemic strain was not decreased by intensive handwashing with 3% hexachlorophene soap. Parenteral antibiotic treatment of affected babies was found to be associated with protracted illness, while oral colistin therapy successfully limited the course of diarrhea in all treated infants. Neonatal infection by an enteropathogenic bacterium not identified by traditional techniques and the resultant inappropriate use of parenteral antibiotic therapy are shown to be important causative factors in "idiopathic intractable diarrhea of infancy."PARAINFLUENZA VIRUS EPIDRMI0IX)GY. Carl D. Rrandt, Hyun W. Kim, Robert N. Chanock, Robert H. Parrott. George Washington University and Research Foundation of Children's Hospital, Washington, D.C. 20009Between October 195...