Zareba-Szczudlik Julia, Romejko-Wolniewicz Ewa, Lewandowski Zbigniew, Rozanska Hanna, Malinowska-Polubiec Aneta, Dobrowolska-Redo Agnieszka, Wilczynski Jan, Czajkowski Krzysztof
2nd Department of Obstetrics and Gynecology, Medical University of Warsaw , Poland.
Department of Epidemiology, Medical University of Warsaw, Poland.
Neuro Endocrinol Lett. 2017 Dec;38(7):502-508.
Amoxicillin is a broad-spectrum beta-lactam antibiotic. Due to its low toxicity, it is commonly used in obstetrics. The objective of this study was to assess amoxicillin concentrations in amniotic fluid, umbilical blood, placenta and maternal serum two hours following oral administration among pregnant women at term and to assess obstetric and non-obstetric factors that might affect amoxicillin's penetration of these tissues.
A total of 30 full-term pregnant women who qualified for elective Caesarean delivery were included in the study. Amoxicillin at a dose of 500 mg was administered prior to surgery. Amoxicillin levels were determined by diffusion microbial assay.
The maternal serum, placental, umbilical blood and amniotic fluid levels of amoxicillin two hours after oral administration were 2.18±1.30 µg/g, 1.00±0.71 µg/g, 1.00±0.73 µg/g, and 0.67±0.59 µg/g, respectively (Table 2). Maternal serum levels of amoxicillin were significantly higher compared to other tissues (p<0.05).
If the target tissues for the use of antibiotic drugs in pregnant patients are the fetus and/or the placenta, the drug should be administered in a higher-than-standard dose than that used to treat infections in non-pregnant patients. Considering that there is a maximum absorbable dose following oral administration, intravenous administration should be considered to prevent failure of antibiotic treatment. A higher dose of amoxicillin should be considered in obese mothers.
阿莫西林是一种广谱β-内酰胺类抗生素。因其毒性低，常用于产科。本研究的目的是评估足月孕妇口服阿莫西林两小时后羊水、脐血、胎盘和母血清中的阿莫西林浓度，并评估可能影响阿莫西林穿透这些组织的产科和非产科因素。
本研究共纳入30例符合择期剖宫产条件的足月孕妇。术前给予500mg阿莫西林。采用扩散微生物测定法测定阿莫西林水平。
口服阿莫西林两小时后，母血清、胎盘、脐血和羊水的阿莫西林水平分别为2.18±1.30μg/g、1.00±0.71μg/g、1.00±0.73μg/g和0.67±0.59μg/g（表2）。与其他组织相比，母血清中的阿莫西林水平显著更高（p<0.05）。
如果孕妇使用抗生素药物的靶组织是胎儿和/或胎盘，则药物的给药剂量应高于治疗非孕妇感染时使用的标准剂量。考虑到口服给药有最大可吸收剂量，应考虑静脉给药以防止抗生素治疗失败。肥胖母亲应考虑使用更高剂量的阿莫西林。
