Abstract
OBJECTIVES: To determine maternal-fetal transplacental passage of vancomycin in the ex vivo human placental perfusion model. METHODS: Six term placentas were collected immediately after delivery and perfused with physiologic medium using the single cotyledon perfusion system. Vancomycin was added to the maternal medium and perfused through the maternal circulation of the cotyledon. Over a 1-h period in an open system, samples of the perfusate were collected at defined intervals from the fetal venous catheter and from the maternal effluence to assess vancomycin transfer. Thereafter, the system was closed for 1-5 h to establish accumulation. Transport fraction and clearance indexes were calculated by perfusing antipyrine 14C (positive control). Vancomycin was estimated by high pressure liquid chromatography and antipyrine 14C concentration was determined by liquid scintillation. RESULTS: Mean vancomycin maternal peak and trough concentrations ranged from 30.0 to 51.5 microg/ml and 7.7 to 16.4 microg/ml, respectively. Clearance indexes were minimal with a mean peak range of 0.000-0.080 and a mean trough range of 0.00-0.17. For each placenta, transport fraction for antipyrine 14C was > 1.85 with a single pass of > 40%. No accumulation of vancomycin was noted when the system was closed for 1-5 h. The mean peak clearance index was zero after perfusing the placenta for up to 5 h with 35.8 microg/ml of vancomycin. CONCLUSION: Transplacental passage of vancomycin was minimal in the ex vivo human placental perfusion model, with no detectable accumulation.
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Selected References
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- Andrews J. I., Diekema D. J., Hunter S. K., Rhomberg P. R., Pfaller M. A., Jones R. N., Doern G. V. Group B streptococci causing neonatal bloodstream infection: antimicrobial susceptibility and serotyping results from SENTRY centers in the Western Hemisphere. Am J Obstet Gynecol. 2000 Oct;183(4):859–862. doi: 10.1067/mob.2000.108839. [DOI] [PubMed] [Google Scholar]
- Bourget P., Fernandez H., Delouis C., Ribou F. Transplacental passage of vancomycin during the second trimester of pregnancy. Obstet Gynecol. 1991 Nov;78(5 Pt 2):908–911. [PubMed] [Google Scholar]
- Challier J. C. Criteria for evaluating perfusion experiments and presentation of results. Contrib Gynecol Obstet. 1985;13:32–39. [PubMed] [Google Scholar]
- Fernandez M., Hickman M. E., Baker C. J. Antimicrobial susceptibilities of group B streptococci isolated between 1992 and 1996 from patients with bacteremia or meningitis. Antimicrob Agents Chemother. 1998 Jun;42(6):1517–1519. doi: 10.1128/aac.42.6.1517. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kelkar P. S., Li J. T. Cephalosporin allergy. N Engl J Med. 2001 Sep 13;345(11):804–809. doi: 10.1056/NEJMra993637. [DOI] [PubMed] [Google Scholar]
- Kershaw B. P., Monnier H. L., Mason J. H. Visual compatibility of premixed theophylline or heparin with selected drugs for i.v. administration. Am J Hosp Pharm. 1993 Jul;50(7):1360, 1362-3. [PubMed] [Google Scholar]
- Lin F. Y., Azimi P. H., Weisman L. E., Philips J. B., 3rd, Regan J., Clark P., Rhoads G. G., Clemens J., Troendle J., Pratt E. Antibiotic susceptibility profiles for group B streptococci isolated from neonates, 1995-1998. Clin Infect Dis. 2000 Jul 24;31(1):76–79. doi: 10.1086/313936. [DOI] [PubMed] [Google Scholar]
- Najari Z., Rusho W. J. Compatibility of commonly used bone marrow transplant drugs during Y-site delivery. Am J Health Syst Pharm. 1997 Jan 15;54(2):181–184. doi: 10.1093/ajhp/54.2.181. [DOI] [PubMed] [Google Scholar]
- Reyes M. P., Ostrea E. M., Jr, Cabinian A. E., Schmitt C., Rintelmann W. Vancomycin during pregnancy: does it cause hearing loss or nephrotoxicity in the infant? Am J Obstet Gynecol. 1989 Oct;161(4):977–981. doi: 10.1016/0002-9378(89)90766-7. [DOI] [PubMed] [Google Scholar]