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头孢甲肟在妊娠晚期的胎盘转运。

Placental transfer of cefmenoxime in late pregnancy.

作者信息

Bergogne-Bérézin E, Bryskier A, Berthelot G, Ravina J H, Vernant D

出版信息

Chemotherapy. 1985;31(1):1-5. doi: 10.1159/000238306.

Abstract

The broad spectrum of activity and the beta-lactamase stability of cefmenoxime provide this new cephalosporin a possible efficacy in the treatment of obstetrical infections. This study was designed to evaluate the placental transfer of cefmenoxime. The study group consisted of 21 pregnant women undergoing a cesarian section. After a single intramuscular injection of 1 g of cefmenoxime, samples of maternal blood and amniotic fluid were taken 30 min before and at delivery; the same samples as well as umbilical cord blood samples were also taken 1, 2, 3 or 4 h after the injection, in order to evaluate the kinetics of the drug. The antibiotic assay was carried out by microbiological procedure. The results of the study showed (1) a peak level of 16 micrograms/ml in maternal serum, with a slow decrease and a residual value of 3 micrograms/ml at 4 h; (2) increasing levels of the drug in cord blood, with a peak value of 4.8 micrograms/ml; (3) a progressive diffusion of cefmenoxime in amniotic fluid, reaching the highest value of 4.7 micrograms/ml at 3 h, and (4) parallel kinetics of the drug in amniotic fluid and in cord blood. On the whole, this study showed a significant placental transfer of cefmenoxime, achieving therapeutic concentrations required against microorganisms responsible for obstetrical infections.

摘要

头孢甲肟的广谱抗菌活性及对β-内酰胺酶的稳定性,使这种新型头孢菌素在治疗产科感染方面具有潜在疗效。本研究旨在评估头孢甲肟的胎盘转运情况。研究组由21例行剖宫产的孕妇组成。单次肌内注射1g头孢甲肟后,分别在分娩前30分钟和分娩时采集母血及羊水样本;注射后1、2、3或4小时,采集相同样本及脐带血样本,以评估药物动力学。采用微生物学方法进行抗生素检测。研究结果显示:(1)母血中峰值浓度为16μg/ml,随后缓慢下降,4小时时残留值为3μg/ml;(2)脐带血中药物浓度逐渐升高,峰值为4.8μg/ml;(3)头孢甲肟在羊水中逐渐扩散,3小时时达到最高值4.7μg/ml;(4)羊水中和脐带血中药物动力学呈平行关系。总体而言,本研究表明头孢甲肟可通过胎盘大量转运,达到治疗产科感染相关微生物所需的治疗浓度。

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