Antibiotic Concentration in Maternal Blood, Cord Blood and Placental Tissue in Women with Chorioamnionitis

Maberry, Mark C.; Trimmer, Kenneth J.; Bawdon, Roger E.; Sobhi, Sohrab; Dax, Jody B.; Gilstrap, Larry C.

doi:10.1159/000294878

Cited by 17 publications

(5 citation statements)

References 4 publications

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“…This finding was believed by the authors to be due to insensitivity of their assay rather than to lack of placental transfer. The placental transfer of ticarcillin‐clavulanic acid has been reported by others [20].…”

Section: Discussionmentioning

confidence: 54%

First‐trimester exposure to amoxycillin/clavulanic acid: a prospective, controlled study

Berkovitch

Diav–Citrin

Greenberg

et al. 2004

Brit J Clinical Pharma

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AimsThe number of published studies on the use of amoxycillin/clavulanic acid during pregnancy is small and so is the number of pregnancies investigated in those studies. In this study we wished to investigate prospectively the safety of intrauterine exposure to amoxycillin/clavulanic acid in a relatively large cohort of women. MethodsWomen treated ( n = 191) with amoxycillin/clavulanic acid during the first trimester of pregnancy were recruited from two teratogen information centres in Israel. Exposed women were matched for age, smoking habits and alcohol consumption with 191 controls exposed to amoxycillin only for similar medical indications. ResultsMaternal age, birth weight, gestational age at delivery, rates of live births and abortions were comparable between the two groups. Rates of major malformations in the amoxycillin/clavulanic acid group (3/158, 1.9%) did not differ significantly from controls (5/163, 3%) ( P = 0.49, relative risk = 0.62, 95% confidence interval 0.15, 2.55), and were within the expected baseline risk for the general population. ConclusionThese data suggest that exposure to amoxycillin/clavulanic acid during pregnancy is unlikely to be associated with an increased risk of malformations.

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Section: Discussionmentioning

confidence: 54%

First‐trimester exposure to amoxycillin/clavulanic acid: a prospective, controlled study

Berkovitch

Diav–Citrin

Greenberg

et al. 2004

Brit J Clinical Pharma

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“…Samples were taken from the central compartment at 0.5, 1, 3, 6, 6.5, 9, and 12 h and from the peripheral compartment at 0.5, 3, 6, 9, and 12 h. Ampicillin and sulbactam half-lives were determined for the central compartment from the slope of the log concentration-versus-time curve. Ampicillin and sulbactam concentrations were determined by high-pressure liquid chromatography in the laboratory of Roger Bawdon as previously described (11). The coefficients of variation for ampicillin and sulbactam were less than 10%, and the assay was linear from 1 to 200 g/ml.…”

Section: Methodsmentioning

confidence: 99%

Pharmacodynamics of Ampicillin-Sulbactam in an In Vitro Infection Model againstEscherichia coliStrains with Various Levels of Resistance

Lamp

Vickers

1998

Antimicrob Agents Chemother

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The activity of ampicillin-sulbactam against β-lactamase-producing Escherichia coli has been questioned. Therefore, in this study, the killing activity of ampicillin-sulbactam was investigated in an in vitro infection model which simulates human pharmacokinetics. One ampicillin-sensitive strain (E. coli ATCC 25922, ampicillin-sulbactam MIC = 4/2 μg/ml) and three ampicillin-resistant TEM-1-producing strains with various levels of ampicillin-sulbactam resistance (EC11, MIC = 4/2 μg/ml; TIM2, MIC = 12/6 μg/ml; and GB85, MIC > 128/64 μg/ml) were studied. The E. coli strains were exposed to ampicillin-sulbactam at a starting inoculum of 6 to 7 log10CFU/ml. Ampicillin-sulbactam was infused over 30 min to simulate doses of 3 and 1.5 g every 6 h for 24 h. The 3-g ampicillin-sulbactam dose was bactericidal against E. coliATCC 25922, EC11, and TIM2. The 1.5-g dose displayed bactericidal activity against ATCC 25922 and EC11 similar to that of the higher dose but failed to kill TIM2 due to inadequate time above the MIC and increased MICs over 24 h. GB85 was highly resistant and grew similarly to controls. Despite an MIC at 107 CFU/ml indicating resistance (20/10 μg/ml), TIM2 was killed by the 3-g dose of ampicillin-sulbactam. Current MIC breakpoints may not adequately portray the activity of ampicillin-sulbactam, considering both the activity in in vitro infection models and clinical data.

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“…The normal treatment is to provide gentamicin every 8-24 hours and ampicillin every 6-6 hours intravenously till birth 42 . The common pathogenic organisms causing intra-amniotic infection are likewise covered by second-and third-generation cephalosporins, extended-spectrum penicillins, and, like ampicillin and gentamicin, these medications cross the placenta and have equivalent maternal and cord blood levels 43 . These antibiotics produce therapeutic serum concentrations in the fetus and have high efficacy against group B streptococcus and E. coli, the two main causes of neonatal sepsis.…”

Section: Managementmentioning

confidence: 99%

The Adverse Outcomes of Chorioamnionitis on the Pregnant Female and Their Fetus

Bambani,

Kedia

2023

Int J Res Rev

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Introduction: Chorioamnionitis is an intra-amniotic infection caused by an ascending polymicrobial bacterial infection. Triple I (intrauterine inflammation or infection or both) is also proposed to replace chorioamnionitis due to its imprecise definition and variable clinical manifestations. Intraamniotic infection is characterized by inflammation of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Maternal fever, uterine tenderness, maternal tachycardia, fetal tachycardia, and purulent fluid coming from the cervical os (the cervical opening can be external, near the vagina, or internal, near the uterus) are the key clinical findings that are crucial for the diagnosis of clinical chorioamnionitis. Clinically, intra-amnionitic infections have been linked to severe morbidity and death in pregnant women, fetuses, and newborns. Method: A systematic search of PubMed, Embase, LitCovid, MedRxiv, BioRxiv, Google Scholar, EBSCO MEDLINE, CINAHL and Scopus electronic database was done using key words like Chorioamnionitis, adverse complication in pregnancy to mother and her fetus associated with intrauterine infection, Intraamniotic inflammation and triple I. Studies have been included from January 2015 to December 2022. Result: Chorioamnionitis is most typically caused by ascending infection and is frequently linked with premature membrane rupture. Chorioamnionitis is typically caused by a polymicrobial infection, with Ureaplasma urealyticum, Mycoplasma hominis, and Gram-negative anaerobes being common pathogens. Antimicrobial drugs, antipyretics, rapid treatment, and supportive care are the mainstays of management. Conclusion: Overall, this review provides a better understanding of Chorioamnionitis and its potential impact on public health. By shedding light on this emerging disease, we hope to contribute to ongoing efforts to prevent and treat of this serious disorder. Keywords: Chorioamnionitis, Intrauterine Infection, Pregnancy, adverse complication, Triple I, Intraamniotic Inflammation

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Antibiotic Concentration in Maternal Blood, Cord Blood and Placental Tissue in Women with Chorioamnionitis

Cited by 17 publications

References 4 publications

First‐trimester exposure to amoxycillin/clavulanic acid: a prospective, controlled study

First‐trimester exposure to amoxycillin/clavulanic acid: a prospective, controlled study

Pharmacodynamics of Ampicillin-Sulbactam in an In Vitro Infection Model againstEscherichia coliStrains with Various Levels of Resistance

The Adverse Outcomes of Chorioamnionitis on the Pregnant Female and Their Fetus

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