Transplacental Passage of Azidocillin, Ampicillin and Penicillin G during Early and Late Pregnancy

Wasz-Höckert, O; Nummi, S.; Vuopala, Salme; Järvinen, Pentti A.

doi:10.3109/inf.1970.2.issue-2.09

Cited by 24 publications

(16 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The concentration of this drug in the maternal plasma were higher than those of ampicillin, while the reverse was found in fetal plasma and amniotic fluid. The fetal and amniotic fluid levels of acidocillin were lower than those of ampicillin, also after oral application [Wasz-Höckert et al, 1970]. Similar results were obtained during early pregnancy and at term except that the concentra tions of the drug in the maternal blood at term appeared lowered, possibly due to decreased absorption prior to and during labor (table IV, V).…”

Section: Azidocillinsupporting

confidence: 74%

“…Similar conclusions were reached in more recent studies involving a larger number of patients (tables IV, V) [Wasz-Höckert et al, 1970;Elek et al, 1972]. The concentrations of penicillin G reached in fetal blood were lower than those of other penicillin analogues such as ampicillin and carbenicillin, both during early pregnancy and at term.…”

Section: Benzylpenicillin (Penicillin G)supporting

confidence: 72%

“…The placental levels were generally lower than the maternal plasma levels for the first few hours after administration of the drug; then, placental levels may even exceed maternal plasma levels during time periods where both concentrations were much below 1 pg/ml or g, respectively. The drug levels in the fetal blood decreased at a slower rate than those in maternal blood so that from 2 h after drug application on the fetal drug levels exceeded the corresponding maternal values consider ably (table I) [Wasz-Höckert et al, 1970] Following oral application of ampicillin, the maximal levels in fetal blood were reached later (at 2-3 h) than those in maternal blood (at < 1 h). Oral application resulted in low fetal and placental drug levels (below 0.2 pg/g).…”

Section: Transfer During the First And Second Trimestermentioning

confidence: 97%

See 2 more Smart Citations

Clinical Pharmacokinetics in Pregnancy and Perinatology

H¹

1987

Dev Pharmacol Ther

View full text Add to dashboard Cite

Ampicillin has been most thoroughly studied in regard to placental transfer. Both during the first/second trimester and at term, fetal drug levels rose slowly to reach values similar to those in the maternal circulation 1-3 h after maternal drug administration; thereafter, fetal drug levels exceeded corresponding maternal values. Amniotic fluid levels were low during early gestational periods; during late gestation these levels were significant and even exceeded corresponding maternal values 6-8 h after drug administration. Slow exchange rates and fetal micturation may be responsible for the elevated ampicillin levels during late gestation. Administration via the intramuscular (recommended with 0.5 g every 4-6 h) or intravenous routes, but not by the oral route, resulted in adequate drug levels. Because of increased plasma clearance of ampicillin during pregnancy, a dose increase in pregnant patients may be necessary to obtain adequate drug levels. Amoxillin and azidocillin have been suggested to give effective drug levels even after oral administration, except during labor. The fetal levels of epicillin and benzylpenicillin (Penicillin G) were lower than the corresponding maternal values; amniotic fluid concentrations of these two drugs were elevated during late, but very low during early gestation, similar to the situation with ampicillin. Methicillin and sulbenicillin were effectively transfered across the placenta (similar to ampicillin), while dicloxacillin was not. The low concentrations of dicloxacillin in the fetus and amniotic fluid may be the results of extensive protein binding (>90%) of this drug in maternal blood. Other highly bound penicillins such as cloxacillin and flucloxacillin have not yet been investigated in regard to placental transfer. Excretion of penicillins in human milk was usually very limited. Following therapeutic doses, the mean milk concentrations were 0.1-0.6 pg/ml for amoxicillin, 0.1-0.2 pg/ml for epicillin, about 0.5 pg/ml for sulbactam, 2-2.5 pg/ml for ticarcillin, and 0.1-0.4 pg/ml for aztreonam.

show abstract

Section: Azidocillinsupporting

confidence: 74%

Section: Benzylpenicillin (Penicillin G)supporting

confidence: 72%

Section: Transfer During the First And Second Trimestermentioning

confidence: 97%

See 1 more Smart Citation

Clinical Pharmacokinetics in Pregnancy and Perinatology

H¹

1987

Dev Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…74 Amniotic fluid concentrations were comparable to maternal serum levels 78 and were considered sufficient to inhibit penicillin-sensitive bacteria. 72, 73, 75, 78 Based on renal elimination rates of penicillin in the 3 rd trimester, a four-hour dosing interval is considered optimal to achieve adequate amniotic fluid levels that will inhibit penicillin-sensitive bacteria. 72 …”

Section: Resultsmentioning

confidence: 99%

Prophylaxis and Treatment of Anthrax in Pregnant Women

Meaney‐Delman¹,

Rasmussen²,

Beigi³

et al. 2013

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Objective To review the safety and pharmacokinetics of antibiotics recommended for anthrax post-exposure prophylaxis and treatment in pregnant women. Data Sources Articles were identified in the PUBMED database from inception through December 2012 by searching the keywords ([“pregnancy]” and [generic antibiotic name]). Additionally, hand searches of references from REPROTOX, TERIS, review articles and Briggs’ Drugs in Pregnancy and Lactation were performed. Methods of Study Selection Articles included in the review contain primary data related to the safety and pharmacokinetics among pregnant women of five antibiotics recommended for anthrax post-exposure prophylaxis and treatment (ciprofloxacin, levofloxacin, moxifloxacin, doxycycline, amoxicillin), and of nine additional antibiotics recommended as part of the treatment regimen (penicillin, ampicillin, linezolid, clindamycin, meropenem, doripenem, rifampin, chloramphenicol, or vancomycin). Tabulation, Integration and Results The PUBMED search identified 3850 articles for review. Reference hand searching yielded nine additional articles. In total, 112 articles met the inclusion criteria. Conclusions Overall, safety and pharmacokinetic information is limited for these antibiotics. Although small increases in risks for certain anomalies have been observed with some antibiotics recommended for prophylaxis and treatment of anthrax, the absolute risk of these antibiotics appears low. Given the high morbidity and mortality associated with anthrax, antibiotics should be dosed appropriately to ensure that antibiotic levels can be achieved and sustained. Dosing adjustments may be necessary for the beta lactam antibiotics and the fluoroquinolones to achieve therapeutic levels in pregnant women. Data indicate that the beta lactam antibiotics, the fluoroquinolones, and, to a lesser extent, clindamycin enter the fetal compartment, an important consideration in the treatment of anthrax, as these antibiotics may provide additional fetal benefit in the 2nd and 3rd trimesters of pregnancy. Additional well designed safety and pharmacokinetic studies are needed.

show abstract

“…Antimicrobial activity is present in human amniotic fluid, fetus, and bronchial secretions (BENGTSSON et al 1979;WAsz-HoCKERT et al 1970). In mice, radioactivity is ubiquitously distributed among tissues outside the CNS.…”

Section: Azidocillinmentioning

confidence: 99%

Pharmacokinetics of β-Lactam Antibiotics

Kwan¹

1983

Antibiotics

View full text Add to dashboard Cite

Transplacental Passage of Azidocillin, Ampicillin and Penicillin G during Early and Late Pregnancy

Cited by 24 publications

References 13 publications

Clinical Pharmacokinetics in Pregnancy and Perinatology

Clinical Pharmacokinetics in Pregnancy and Perinatology

Prophylaxis and Treatment of Anthrax in Pregnant Women

Pharmacokinetics of β-Lactam Antibiotics

Contact Info

Product

Resources

About