PHARMACOKINETIC AND CLINICAL STUDIES ON CEFTIZOXIME IN THE PERINATAL PERIOD

• Published in: Japanese journal of antibiotics 1988/08/25, Vol.41(8), pp.1164-1171
• Main Authors: YAMAMOTO, TAKAO, YASUDA, JINSUKE, KANAO, MASAAKI, OKADA, HIROJI
• Format: Article
• Language: Japanese
• Subjects: Adult; Amniotic Fluid - metabolism; Ceftizoxime - administration & dosage; Ceftizoxime - pharmacokinetics; Ceftizoxime - therapeutic use; Chorioamnionitis - drug therapy; Chorioamnionitis - metabolism; Drug Evaluation; Endometritis - drug therapy; Endometritis - metabolism; Female; Fetal Blood - metabolism; Humans; Injections, Intravenous; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications, Infectious - drug therapy; Pregnancy Complications, Infectious - metabolism; Puerperal Infection - drug therapy; Puerperal Infection - metabolism; Pyelonephritis - drug therapy; Pyelonephritis - metabolism
• ISSN: 0368-2781; 2186-5477
• DOI: 10.11553/antibiotics1968b.41.1164

Pharmacokinetic and clinical studies were carried out on the use of ceftizoxime (CZX) in the perinatal period. The results obtained are summarized below. 1. Mean maternal serum concentrations of CZX reached 57.3 μg/ml at about 15 minutes after a single intravenous injection of CZX 1 g and then gradually decreased to 13.1 μg/ml in 1 hour and 55 minutes, 3.59 μg/ml in 4 hours and 20 minutes and 0.11 μg/ml in 17 hours and 51 minutes. CZX in umbilical cord serum was at detectable concentrations soon after administration and peaked to 23.5 μg/ml in 32 minutes. Although the concentrations in umbilical cord serum gradually decreased thereafter, they were higher than those in maternal serum at 3 hours and more after an injection and was 0.41 μg/ml at 17 hours and 51 minutes. The CZX in amniotic fluid became detectable a little later than CZX in umbilical cord serum. The concentration of CZX in amniotic fluid was below 1.00 μg/ml at 30 minutes after administration. Concentrations then gradually increased to 21.3 μg/ml in 1 hour and 55 minutes and, even in 17 hours and 51 minutes, they were as high as 9.44 μg/ml. 2. In the clinical evaluation, CZX was given to a total of 7 cases, i.e., 1 of amnionitis, 2 of puerperal endometritis, 1 of puerperal fever, and 3 of pyelonephritis. The treatment showed satisfactory results, i.e. excellent result was obtained in 1 case, good in 5 and poor in 1 with an clinical efficacy rate of 85.7%. Microbiological examinations resulted in the isolation of 5 bacterial strains of 4 species and 1 fungal strain from 5 cases. After CZX administration, all bacterial strains were eradicated, but the fungal strain was replaced with a strain of coagulase-negative Staphylococcus. Neither side effects nor abnormal laboratory test data were observed in any of the cases (mothers and babies) treated with CZX.