Understanding the Pharmacokinetics of Antibiotics in Pregnancy: Is There a Role for Therapeutic Drug Monitoring? A Narrative Review.
Journal
Therapeutic drug monitoring
ISSN: 1536-3694
Titre abrégé: Ther Drug Monit
Pays: United States
ID NLM: 7909660
Informations de publication
Date de publication:
01 02 2022
01 02 2022
Historique:
received:
19
08
2021
accepted:
03
11
2021
pubmed:
14
12
2021
medline:
24
3
2022
entrez:
13
12
2021
Statut:
ppublish
Résumé
Antibiotics are commonly used during pregnancy. However, physiological changes during pregnancy can affect the pharmacokinetics of drugs, including antibiotics, used during this period. Pharmacokinetic evaluations have shed light on how antibiotics are affected during pregnancy and have influenced dosing recommendations in this context. A narrative review was conducted and included reports providing data reflecting drug distribution and exposure in the context of pregnancy. Pharmacokinetic parameters of antibiotics in pregnancy and transplacental passage of antibiotics are comprehensively presented. Knowledge about the impact on pharmacokinetics and fetal exposure is especially helpful for complicated or severe infections, including intra-amniotic infection and sepsis in pregnancy, where both mother and fetus are at risk. Further studies are warranted to consolidate the role of therapeutic drug monitoring in complicated or severe infections in pregnant patients.
Identifiants
pubmed: 34897239
doi: 10.1097/FTD.0000000000000950
pii: 00007691-202202000-00006
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
50-64Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Matsui DM. Therapeutic drug monitoring in pregnancy. Ther Drug Monit. 2012;34:507–511.
Stojanova J, Luque S. Therapeutic drug monitoring: more than avoiding toxicity. In: Udy A, Roberts J, Lipman J, eds. Antibiotic Pharmacokinetic/Pharmacodynamic Considerations in the Critically Ill. Singapore: ADIS; 2018:chap 9.
Pariente G, Leibson T, Carls A, et al. Pregnancy-associated changes in pharmacokinetics: a systematic review. Plos Med. 2016;13:e1002160.
McCormack SA, Best BM. Obstetric pharmacokinetic dosing studies are urgently needed. Front Pediatr. 2014;2:9.
Rac H, Gould AP, Eiland LS, et al. Common bacterial and viral infections: review of management in the pregnant patient. Ann Pharmacother. 2019;53:639–651.
Ansari J, Carvalho B, Shafer SL, et al. Pharmacokinetics and pharmacodynamics of drugs commonly used in pregnancy and parturition. Anesth Analg. 2016;122:786–804.
Committee on Obstetric Practice. Committee opinion no. 712: intrapartum management of intraamniotic infection. Obstet Gynecol. 2017;130:e95–e101.
Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin no. 199: use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2018;132:e103–e119.
Prevention of Group B. Streptococcal early-onset disease in newborns: ACOG committee opinion, number 782. Obstet Gynecol. 2019;134:e19–e40.
Philipson A. Pharmacokinetics of antibiotics in pregnancy and labour. Clin Pharmacokinet. 1979;4:297–309.
Chow AW, Jewesson PJ. Pharmacokinetics and safety of antimicrobial agents during pregnancy. Rev Infect Dis. 1985;7:287–313.
Bookstaver PB, Bland CM, Griffin B, et al. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015;35:1052–1062.
Patil AS, Sheng JS, Dotters-Katz SK, et al. Principles of anti-infective dosing in pregnancy. Clin Ther. 2016;38:2006–2015.
Pavek P, Ceckova M, Staud F. Variation of drug kinetics in pregnancy. Curr Drug Metab. 2009;10:520–529.
Koren G, Pariente G. Pregnancy-associated changes in pharmacokinetics and their clinical implications. Pharm Res. 2018;35:61.
Heikkilä AM, Erkkola RU. The need for adjustment of dosage regimen of penicillin V during pregnancy. Obstet Gynecol. 1993;81:919–921.
Philipson A. Pharmacokinetics of ampicillin during pregnancy. J Infect Dis. 1977;136:370–376.
Chamberlain A, White S, Bawdon R, et al. Pharmacokinetics of ampicillin and sulbactam in pregnancy. Am J Obstet Gynecol. 1993;168:667–673.
Andrew MA, Easterling TR, Carr DB, et al. Amoxicillin pharmacokinetics in pregnant women: modeling and simulations of dosage strategies. Clin Pharmacol Ther. 2007;81:547–556.
Muller AE, DeJongh J, Oostvogel PM, et al. Amoxicillin pharmacokinetics in pregnant women with preterm premature rupture of the membranes. Am J Obstet Gynecol. 2008;198:108.e1–108.e6.
Muller AE, Dörr PJ, Mouton JW, et al. The influence of labour on the pharmacokinetics of intravenously administered amoxicillin in pregnant women. Br J Clin Pharmacol. 2008;66:866–874.
Philipson A, Stiernstedt G, Ehrnebo M. Comparison of the pharmacokinetics of cephradine and cefazolin in pregnant and non-pregnant women. Clin Pharmacokinet. 1987;12:136–144.
Popović J, Grujić Z, Sabo A. Influence of pregnancy on ceftriaxone, cefazolin and gentamicin pharmacokinetics in caesarean vs. non-pregnant sectioned women. J Clin Pharm Ther. 2007;32:595–602.
Elkomy MH, Sultan P, Drover DR, et al. Pharmacokinetics of prophylactic cefazolin in parturients undergoing cesarean delivery. Antimicrob Agents Chemother. 2014;58:3504–3513.
Philipson A, Stiernstedt G. Pharmacokinetics of cefuroxime in pregnancy. Am J Obstet Gynecol. 1982;142:823–828.
Bourget P, Fernandez H, Quinquis V, et al. Pharmacokinetics and protein binding of ceftriaxone during pregnancy. Antimicrob Agents Chemother. 1993;37:54–59.
Salman S, Rogerson SJ, Kose K, et al. Pharmacokinetic properties of azithromycin in pregnancy. Antimicrob Agents Chemother. 2010;54:360–366.
Fischer JH, Sarto GE, Habibi M, et al. Influence of body weight, ethnicity, oral contraceptives, and pregnancy on the pharmacokinetics of azithromycin in women of childbearing age. Antimicrob Agents Chemother. 2012;56:715–724.
Muller AE, Mouton JW, Oostvogel PM, et al. Pharmacokinetics of clindamycin in pregnant women in the peripartum period. Antimicrob Agents Chemother. 2010;54:2175–2181.
Wang X, Nanovskaya TN, Zhan Y, et al. Pharmacokinetics of metronidazole in pregnant patients with bacterial vaginosis. J Matern-Fetal Neonatal. 2011;24:444–448.
Locksmith GJ, Chin A, Vu T, et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol. 2005;105:473–479.
Bernard B, Abate M, Thielen PF, et al. Maternal-fetal pharmacological activity of amikacin. J Infect Dis. 1977;135:925–932.
Flores-Mercado F, García-Mercado JL, Estopier-Jáuregui C, et al. Clinical pharmacology of amikacin sulphate: blood, urinary and tissue concentrations in the terminal stage of pregnancy. J Int Med Res. 1977;5:292–294.
Bourget P, Fernandez H, Delouis C, et al. Transplacental passage of vancomycin during the second trimester of pregnancy. Obstet Gynecol. 1991;78:908–911.
Peiker G, Traeger A, Pischke U, et al. Studies on the pharmacokinetics of the compound preparation sulfamerazine/trimethoprim (Berlocombin-200) in pregnancy [in German]. Die Pharmazie. 1982;37:578–583.
Nemutlu E, Kir S, Eroglu H, et al. Comparison of pharmacokinetic profiles of moxifloxacin in Caesarean versus non-pregnant sectioned women by fully validated HPLC with fluorescence detection. Comb Chem High Throughput Screen. 2010;13:502–509.
Van Kampenhout E, Bolhuis MS, Alffenaar J-WC, et al. Pharmacokinetics of moxifloxacin and linezolid during and after pregnancy in a patient with multidrug-resistant tuberculosis. Eur Respir J. 2017;49:1601724.
Voigt R, Schröder S, Peiker G. Pharmacokinetic studies of azlocillin and piperacillin during late pregnancy. Chemotherapy. 1985;31:417–424.
Heikkilä A, Erkkola R. Pharmacokinetics of piperacillin during pregnancy. J Antimicrob Chemother. 1991;28:419–423.
Bourget P, Sertin A, Lesne-Hulin A, et al. Influence of pregnancy on the pharmacokinetic behaviour and the transplacental transfer of the piperacillin-tazobactam combination. Eur J Obstet Gynecol Reprod Biol. 1998;76:21–27.
Nathorst-Böös J, Philipson A, Hedman A, et al. Renal elimination of ceftazidime during pregnancy. Am J Obstet Gynecol. 1995;172(1 pt 1):163–166.
Heikkilä A, Renkonen OV, Erkkola R. Pharmacokinetics and transplacental passage of imipenem during pregnancy. Antimicrob Agents Chemother. 1992;36:2652–2655.
Vella-Brincat JWA, Begg EJ, Kirkpatrick CMJ, et al. Protein binding of cefazolin is saturable in vivo both between and within patients. Br J Clin Pharmacol. 2007;63:753–757.
Allegaert K, Van Mieghem T, Verbesselt R, et al. Cefazolin plasma protein binding saturability during pregnancy. Methods Find Exp Clin Pharmacol. 2009;31:25–28.
Kram JJF, Greer DM, Cabrera O, et al. Does current cefazolin dosing achieve adequate tissue and blood concentrations in obese women undergoing cesarean section?. Eur J Obstet Gynecol Reprod Biol. 2017;210:334–341.
Maggio L, Nicolau DP, DaCosta M, et al. Cefazolin prophylaxis in obese women undergoing cesarean delivery: a randomized controlled trial. Obstet Gynecol. 2015;125:1205–1210.
Pevzner L, Swank M, Krepel C, et al. Effects of maternal obesity on tissue concentrations of prophylactic cefazolin during cesarean delivery. Obstet Gynecol. 2011;117:877–882.
Stitely M, Sweet M, Slain D, et al. Plasma and tissue cefazolin concentrations in obese patients undergoing cesarean delivery and receiving differing pre-operative doses of drug. Surg Infect. 2013;14:455–459.
Swank ML, Wing DA, Nicolau DP, et al. Increased 3-gram cefazolin dosing for cesarean delivery prophylaxis in obese women. Am J Obstet Gynecol. 2015;213:415.e1–415.e8.
Young OM, Shaik IH, Twedt R, et al. Pharmacokinetics of cefazolin prophylaxis in obese gravidae at time of cesarean delivery. Am J Obstet Gynecol. 2015;213:541.e1–541.e7.
ACOG Practice Bulletin No. 120: use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2011;117:1472–1483.
Duffield A, Sultan P, Riley ET, et al. Optimal administration of cefazolin prophylaxis for cesarean delivery. J Perinatol. 2017;37:16–20.
Pollock AA, Tee PE, Patel IH, et al. Pharmacokinetic characteristics of intravenous ceftriaxone in normal adults. Antimicrob Agents Chemother. 1982;22:816–823.
Gilstrap LC, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol. 1988;72:124–125.
Colombo DF, Lew JL, Pedersen CA, et al. Optimal timing of ampicillin administration to pregnant women for establishing bactericidal levels in the prophylaxis of Group B Streptococcus. Am J Obstet Gynecol. 2006;194:466–470.
Ramsey PS, Vaules MB, Vasdev GM, et al. Maternal and transplacental pharmacokinetics of azithromycin. Am J Obstet Gynecol. 2003;188:714–718.
Sutton AL, Acosta EP, Larson KB, et al. Perinatal pharmacokinetics of azithromycin for cesarean prophylaxis. Am J Obstet Gynecol. 2015;212:812.e1–812.e6.
Philipson A, Sabath LD, Charles D. Transplacental passage of erythromycin and clindamycin. N Engl J Med. 1973;288:1219–1221.
Bulska M, Szcześniak P, Pięta-Dolińska A, et al. The placental transfer of erythromycin in human pregnancies with group B streptococcal infection. Ginekol Pol. 2015;86:33–39.
Wear CD, Towers CV, Brown MS, et al. Transplacental passage of clindamycin from mother to neonate. J Perinatol Off J Calif Perinat Assoc. 2016;36:960–961.
Onwuchuruba CN, Towers CV, Howard BC, et al. Transplacental passage of vancomycin from mother to neonate. Am J Obstet Gynecol. 2014;210:352.e1–352.e4.
Ozyuncu O, Nemutlu E, Katlan D, et al. Maternal and fetal blood levels of moxifloxacin, levofloxacin, cefepime and cefoperazone. Int J Antimicrob Agents. 2010;36:175–178.
Löfmark S, Edlund C, Nord CE. Metronidazole is still the drug of choice for treatment of anaerobic infections. Clin Infect Dis. 2010;50(suppl 1):S16–S23.
Ward K, Theiler RN. Once-daily dosing of gentamicin in obstetrics and gynecology. Clin Obstet Gynecol. 2008;51:498–506.
Towers CV, Weitz B. Transplacental passage of vancomycin. J Matern-Fetal Neonatal Med.. 2018;31:1021–1024.
Bar-Oz B, Bulkowstein M, Benyamini L, et al. Use of antibiotic and analgesic drugs during lactation. Drug Saf. 2003;26:925–935.
Acar S, Keskin-Arslan E, Erol-Coskun H, et al. Pregnancy outcomes following quinolone and fluoroquinolone exposure during pregnancy: a systematic review and meta-analysis. Reprod Toxicol. 2019;85:65–74.
Ziv A, Masarwa R, Perlman A, et al. Pregnancy outcomes following exposure to quinolone antibiotics—a systematic-review and meta-analysis. Pharm Res. 2018;35:109.
Yefet E, Schwartz N, Chazan B, et al. The safety of quinolones and fluoroquinolones in pregnancy: a meta-analysis. BJOG Int J Obstet Gynaecol. 2018;125:1069–1076.
Viel-Theriault I, Fell DB, Grynspan D, et al. The transplacental passage of commonly used intrapartum antibiotics and its impact on the newborn management: a narrative review. Early Hum Dev. 2019;135:6–10.
Moser C, Lerche CJ, Thomsen K, et al. Antibiotic therapy as personalized medicine - general considerations and complicating factors. APMIS Acta Pathol Microbiol Immunol Scand. 2019;127:361–371.
Burlinson CEG, Sirounis D, Walley KR, et al. Sepsis in pregnancy and the puerperium. Int J Obstet Anesth. 2018;36:96–107.
Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock. Crit Care Med. 2017;45:486–552.