Fortunato S J, Bawdon R E, Welt S I, Swan K F
Department of Obstetrics and Gynecology, East Tennessee State University, Quillen-Dishner College of Medicine, Johnson City 37601.
Am J Obstet Gynecol. 1988 Sep;159(3):570-3. doi: 10.1016/s0002-9378(88)80010-3.
As part of our management protocol for preterm premature rupture of membranes, ceftizoxime and tocolysis were used to prolong the latent period and prevent or treat concomitant infection. Ceftizoxime was selected for this protocol based on its physiochemical properties, which favor placental transfer of the drug. Patients achieving steady-state pharmacodynamics (more than three doses of the drug) were considered eligible for study. Ceftizoxime levels were determined by reverse-phase high-pressure liquid chromatography. All levels measured after the first hour of treatment were indicative of the relative concentration of ceftizoxime in the fetal and amniotic fluid compartments when compared with the maternal compartment. Mean (+/- SEM) ceftizoxime levels were 11.96 + 2.35 micrograms/ml in maternal serum, 24.54 +/- 4.78 micrograms/ml in cord serum, and 43.45 +/- 4.97 micrograms/ml in amniotic fluid. Based on its broad antibacterial activity and its high concentration in fetal blood and amniotic fluid, ceftizoxime appears to be an ideal agent for treatment of the intrauterine environment.
作为我们早产胎膜早破管理方案的一部分，使用头孢唑肟和宫缩抑制剂来延长潜伏期并预防或治疗并发感染。选择头孢唑肟用于该方案是基于其理化性质，该性质有利于药物的胎盘转运。达到稳态药效学（超过三剂药物）的患者被认为符合研究条件。头孢唑肟水平通过反相高压液相色谱法测定。与母体 compartment 相比，治疗第一小时后测量的所有水平均表明头孢唑肟在胎儿和羊水 compartment 中的相对浓度。母体血清中头孢唑肟的平均（±SEM）水平为11.96 + 2.35微克/毫升，脐血血清中为24.54±4.78微克/毫升，羊水中为43.45±4.97微克/毫升。基于其广泛的抗菌活性及其在胎儿血液和羊水中的高浓度，头孢唑肟似乎是治疗子宫内环境的理想药物。
