The Transmission of Penicillin through the Placenta

Hutter, Adolph M.; Parks, John

doi:10.1016/s0002-9378(15)30214-3

Cited by 23 publications

(6 citation statements)

References 3 publications

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“…5,33,34 Penicillins are transferred to the fetus and amniotic fluid reaching therapeutic levels. 5,33,34 Penicillins are transferred to the fetus and amniotic fluid reaching therapeutic levels.…”

Section: Resultsmentioning

confidence: 99%

“…6,11 Penicillins are primarily renally excreted via tubular secretion and glomerular filtration. 5,7,10,33,34,35 Penicillins are transferred to the fetus and amniotic fluid reaching therapeutic levels. 6,11 Penicillin VK Gram-positive aerobes including most streptococci/ enterococci, grampositive anaerobes, gram negatives Crosses the human placenta readily.…”

Section: Resultsmentioning

confidence: 99%

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Antibiotic Use in Pregnancy and Lactation

Nahum

Uhl

Kennedy

2006

Obstetrics & Gynecology

182

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Antibiotic Use in Pregnancy and Lactation

Nahum

Uhl

Kennedy

2006

Obstetrics & Gynecology

182

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“…Penicillins G cross the placenta rapidly (Hutter and Parks, 1945;Woltz and Zintel, 1945;Woltz and Wiley, 1946;Wasz-Hockert et al, 1970). The parenteral penicillins G were used mainly for the treatment of severe acute maternal infections caused by streptococcus, pneumococcus, and sensitive staphylococcus in the dataset of the HCCSCA.…”

Section: Discussionmentioning

confidence: 99%

A Population‐based Case‐Control Teratological Study of Three Parenteral Penicillins G

Czeizel

Rockenbauer

Sørensen

et al. 1999

Congenital Anomalies

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The purpose of the study was to check the human teratogenic potential of three penicillins G: parenteral treatments with benzylpenicillin, benzylpenicillin‐procaine, and benzylpenicillin + benzylpenicillin‐procaine during pregnancy in the population‐based dataset of the Hungarian Case‐Control Surveillance of Congenital Abnormalities, 1980–1996. Of 38,151 pregnant women who had babies without any defects (population control group), 303 (0.8%) were treated with penicillin G. Of 22,865 pregnant women who had offspring with congenital abnormalities, 236 (1.O%) were treated with penicillin G (crude OR with 95% CI = 1.3, 1.1–1.5). Of 812 mothers who deliveried babies affected with Down syndrome (patient controls), 15 (1.8%) had penicillin G treatment, and this rate exceeded significantly the figure of both the case and population control groups. This finding needs further studies. The case‐control pair analysis did not indicate a teratogenic risk of three parenteral penicillin G treatments during the second‐third months of gestation, i.e., in the critical period for major congenital abnormalities. The lower use of penicillins G was explained mainly by recall bias in the population control group. Thus, parenteral penicillin G treatments during pregnancy do not present a detectable teratogenic risk to the fetus.

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“… Abbreviation: FDA, Food and Drug Administration. * References 12, 83, 85, 92, 93, 105–108, 110, 111, 117, 120, 122, 125–128, 131–138, 169. a Placental transfer is considered incomplete for drugs with molecular weight >500 kDa or who demonstrate levels in the fetus or embryo that are less than maternal levels or below therapeutic levels in human pharmacokinetic studies.…”

Section: Antibioticsmentioning

confidence: 99%

When One Drug Affects 2 Patients

Bulloch

Carroll

2012

Journal of Pharmacy Practice

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One of the most difficult challenges health care providers encounter is drug selection for pregnant patients. Drug selection can be complex as efficacy and maternal side effects must be weighed against potential risk to the embryo or fetus. Verification of an individual drug's fetal safety is limited as most evidence is deduced from epidemiologic, prospective cohort, or case-control studies. Medication selection for the pregnant inpatient is a particularly complex task as the illnesses and conditions that require hospitalization mandate different medications, and the risk versus benefit ratio can vary significantly compared to the outpatient setting. Some degree of acute pain is not uncommon among inpatients. Acetaminophen is generally considered the drug of choice in pregnancy for mild to moderate acute pain, while most opioids are thought to be safe for short-term use to manage moderate to severe pain. Providing sedation is particularly challenging as the few options available for the general population are further limited by either known increased risk of congenital malformations or very limited human pregnancy data. Propofol is the only agent recommended for continuous sedation, which has a Food and Drug Administration classification as a pregnancy category B medication. Treatment of infections in hospitalized patients requires balancing the microbiology profile against the fetal risk. Older antimicrobials proven generally safe include beta-lactams, and those with proven fetal risks include tetracyclines. However, little to no information regarding gestational use is available on the newer antimicrobials that are frequently employed to treat resistant infections more commonly found in the inpatient setting. Management of maternal blood pressure is based on the severity of blood pressure elevations and not the hypertensive classification. Agents generally considered safe to use in hypertensive pregnant patients include methyldopa, labetolol, and hydralazine, while angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, hydrochlorothiazide, and atenolol should be avoided.

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The Transmission of Penicillin through the Placenta

Cited by 23 publications

References 3 publications

Antibiotic Use in Pregnancy and Lactation

Antibiotic Use in Pregnancy and Lactation

A Population‐based Case‐Control Teratological Study of Three Parenteral Penicillins G

When One Drug Affects 2 Patients

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