FUNDAMENTAL AND CLINICAL STUDIES ON CEFTAZIDIME IN THE PERINATAL PERIOD

• Published in: Japanese journal of antibiotics 1986/08/25, Vol.39(8), pp.2263-2271
• Main Authors: YAMAMOTO, TAKAO, YASUDA, JINSUKE, KANAO, MASAAKI, OKADA, HIROJI
• Format: Article
• Language: Japanese
• Subjects: Adult; Bacterial Infections - drug therapy; Ceftazidime - administration & dosage; Ceftazidime - metabolism; Ceftazidime - therapeutic use; Drug Evaluation; Female; Humans; Injections, Intravenous; Maternal-Fetal Exchange; Pregnancy - metabolism; Pregnancy Complications, Infectious - drug therapy; Pregnancy Trimester, Third; Puerperal Infection - drug therapy
• ISSN: 0368-2781; 2186-5477
• DOI: 10.11553/antibiotics1968b.39.2263

Fundamental and clinical studies were carried out on ceftazidime (CAZ) in the perinatal period, and the results obtained were summarized below. 1. Following bolus intravenous injection of CAZ 2g, maternal serum concentrations of CAZ were as high as 145.3±17.2μg/ml (mean±S. D.) at about 10 minutes, and then gradually decreased to 46.7μg/ml at 2 hours, 5.31μg/ml at 5 hours and 4 minutes, and 1.54μg/ml at 11 hours and 10 minutes. The CAZ was detected in umbilical cord serum immediately after the administration, and concentrations were 31.0±1.54μg/ml at about 10 minutes. Although the concentrations gradually decreased thereafter, they were higher than those in maternal serum at 3 hours and later and was 3.00μg/ml at 11 hours and 10 minutes. The CAZ was detected in amniotic fluid a little later than in umbilical cord serum, and concentrations of CAZ in amniotic fluid were as low as 1.50±0.67μg/ml at about 10 minutes after the administration. Concentrations then gradually increased to 12.8μg/ml at 2 hours and 26.5μg/ml at 5 hours and 4 minutes, and even at 11 hours and 10 minutes, they were as high as 14.2μg/ml. The above results demonstrated that the transfer of CAZ through placental barrier was very rapid and satisfactory. Also, CAZ showed good transfer into amniotic fluid, as well as sufficient retention, and was considered to be an effective antibiotic for prophylaxis of both fetal infections and amniotic fluid infections. 2. In the clinical evaluation of CAZ which was given to a total of 11 cases, i. e., 2 of amnionitis, 8 of puerperal endometritis and 1 of pyelonephritis, treatments showed satisfactory results, i. e., excellent in 6, good in 4 and poor in 1 with an efficacy rate of 90.9%. As to bacteriological examination, 18 strains (15 species) of bacteria were isolated from 9 cases. After CAZ administration, 8 strains were eradicated and 1 strain persisted among 9 strains each of aerobic and anaerobic bacteria with eradication rate of 88.9%. Neither subjective/objective side effects nor abnormal laboratory findings were observed in any of the cases (mothers and babies) treated with CAZ.