Itakura A, Kurauchi O, Mizutani S, Tomoda Y, Matsuzawa K
Department of Obstetrics and Gynecology, Nagoya University School of Medicine.
Jpn J Antibiot. 1995 Jun;48(6):749-53.
The monobactam antibiotic aztreonam (AZT) was administered by intravenous drip infusion to women with intrauterine infections at 6-hour intervals and its concentrations in the maternal blood, umbilical blood, and umbilical tissue were determined at parturition to evaluate its transport to the umbilicus and fetus, and this accumulation in the tissue. Further, umbilical tissue was cultured to detect bacteria and examined histologically to evaluate the efficacy of AZT its treatment of omphalitis. Neither maternal nor umbilical blood showed any signs of drug accumulation, and there was a correlation between maternal and umbilical blood levels of AZT and time lapsed after most recent administration. Umbilical tissue levels of AZT tended to increase with time for about 12 hours after the start of administration, but showed no tendency to further rise thereafter. The umbilical tissue cultures were negative for causative pathogens 12 hours or more after the initial dosing. Histological examination of umbilical tissue was negative for omphalitis 12 hours or more after the start of administration in all but one patient. After the administration of AZT to pregnant women with intrauterine infections, it was detected in the umbilicus and fetus in high concentrations at parturition without appreciable tissue accumulation, newborn infection or adverse reaction. The overall results suggest that AZT is clinical effective when used in the treatment of omphalitis.
对患有宫内感染的女性每隔6小时静脉滴注单环β-内酰胺类抗生素氨曲南(AZT),并在分娩时测定其在母体血液、脐血和脐组织中的浓度,以评估其向脐带和胎儿的转运情况以及在组织中的蓄积情况。此外,对脐组织进行培养以检测细菌,并进行组织学检查以评估AZT治疗脐炎的疗效。母体血液和脐血均未显示出任何药物蓄积的迹象,并且母体和脐血中AZT的水平与最近一次给药后经过的时间之间存在相关性。给药开始后约12小时内,脐组织中AZT的水平倾向于随时间增加,但此后没有进一步升高的趋势。初次给药12小时或更长时间后,脐组织培养物中致病病原体呈阴性。除一名患者外,给药开始12小时或更长时间后,脐组织的组织学检查显示脐炎呈阴性。在对患有宫内感染的孕妇给药AZT后,分娩时在脐带和胎儿中检测到高浓度的AZT,且没有明显的组织蓄积、新生儿感染或不良反应。总体结果表明,AZT用于治疗脐炎时临床有效。