Tobramycin: maternal-fetal pharmacology.
PDF (826K)
Journal: 1977/June - Antimicrobial Agents and Chemotherapy
ISSN: 0066-4804
PUBMED: 856021
Abstract:
To investigate the maternal-fetal transfer of tobramycin (TBM) and its distribution in the fetus, a single dose of 2 mg/kg was administered intramuscularly to 35 pregnant patients (13 first trimester, 22 second trimester) 0.5 to 34 h before hysterectomy. TBM concentration was assayed microbiologically in maternal serum, fetal tissues (placenta, brain, lung, liver, and kidney), and fluids (amniotic, cerebrospinal fluid [CSF], urine, and serum). Mean maternal serum half-life (1.54 h) and mean peak serum concentration of TBM were within ranges reported for nonpregnant adults. In fetal serum, half-life was 5.2 h, and TBM levels did not exceed 0.58 mug/ml. For intervals up to 34 h, the mean TBM concentration in placental tissues was 1.4 mug/g. Concentration differences related to fetal maturation were found for fetal CSF, amniotic fluid, and fetal kidney. No antimicrobial activity was found in the fetal CSF of >16 weeks' gestation. TBM was present predominantly in the second trimester amniotic fluid specimens. Fetal kidney concentrations reached 7.2 mug/g at 34 h after maternal drug administration. Higher TBM concentrations were related to advanced maturation of the fetal kidney. Second trimester fetal urine concentrations for TBM ranged from 0.1 to 3.4 mug/ml, and the fetal urinary half-life was 3.7 h. Knowledge of fetal pharmacology is essential for weighing the fetal benefits or risks of antimicrobial therapy for the infected gravid patient.
Open in
PUBMED | PMC | Google Scholar | Wikipedia
Relations:
Content
Citations
(9)
References
(9)
Drugs
(2)
Chemicals
(1)
Organisms
(1)
Processes
(3)
Anatomy
(2)
Similar articles
Articles by the same authors
Discussion board
Antimicrob Agents Chemother 11(4): 688-694
PMID: 856021

Tobramycin: Maternal-Fetal Pharmacology

Abstract

To investigate the maternal-fetal transfer of tobramycin (TBM) and its distribution in the fetus, a single dose of 2 mg/kg was administered intramuscularly to 35 pregnant patients (13 first trimester, 22 second trimester) 0.5 to 34 h before hysterectomy. TBM concentration was assayed microbiologically in maternal serum, fetal tissues (placenta, brain, lung, liver, and kidney), and fluids (amniotic, cerebrospinal fluid [CSF], urine, and serum). Mean maternal serum half-life (1.54 h) and mean peak serum concentration of TBM were within ranges reported for nonpregnant adults. In fetal serum, half-life was 5.2 h, and TBM levels did not exceed 0.58 μg/ml. For intervals up to 34 h, the mean TBM concentration in placental tissues was 1.4 μg/g. Concentration differences related to fetal maturation were found for fetal CSF, amniotic fluid, and fetal kidney. No antimicrobial activity was found in the fetal CSF of >16 weeks' gestation. TBM was present predominantly in the second trimester amniotic fluid specimens. Fetal kidney concentrations reached 7.2 μg/g at 34 h after maternal drug administration. Higher TBM concentrations were related to advanced maturation of the fetal kidney. Second trimester fetal urine concentrations for TBM ranged from 0.1 to 3.4 μg/ml, and the fetal urinary half-life was 3.7 h. Knowledge of fetal pharmacology is essential for weighing the fetal benefits or risks of antimicrobial therapy for the infected gravid patient.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (826K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.
icon of scanned page 688
688
icon of scanned page 689
689
icon of scanned page 690
690
icon of scanned page 691
691
icon of scanned page 692
692
icon of scanned page 693
693
icon of scanned page 694
694

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Bennett JV, Brodie JL, Benner EJ, Kirby WM. Simplified, accurate method for antibiotic assay of clinical specimens. Appl Microbiol. 1966 Mar;14(2):170–177.[PMC free article] [PubMed] [Google Scholar]
  • BERLIN NI, GOETSCH C, HYDE GM, PARSONS RJ. The blood volume in pregnancy as determined by P32 labeled red blood cells. Surg Gynecol Obstet. 1953 Aug;97(2):173–176. [PubMed] [Google Scholar]
  • Evans CA, Reynolds JM, Reynolds ML, Saunders NR, Segal MB. The development of a blood-brain barrier mechanism in foetal sheep. J Physiol. 1974 Apr;238(2):371–386.[PMC free article] [PubMed] [Google Scholar]
  • Kaplan JM, McCracken GH, Jr, Thomas ML, Horton LJ, Davis N. Clinical pharmacology of tobramycin in newborns. Am J Dis Child. 1973 May;125(5):656–660. [PubMed] [Google Scholar]
  • Lindheimer MD, Katz AI. Pregnancy and the kidney. J Reprod Med. 1973 Jul;11(1):14–18. [PubMed] [Google Scholar]
  • Luft FC, Kleit SA. Renal parenchymal accumulation of aminoglycoside antibiotics in rats. J Infect Dis. 1974 Dec;130(6):656–659. [PubMed] [Google Scholar]
  • Philipson A, Sabath LD, Charles D. Transplacental passage of erythromycin and clindamycin. N Engl J Med. 1973 Jun 7;288(23):1219–1221. [PubMed] [Google Scholar]
  • Ries K, Levison ME, Kaye D. In vitro evaluation of a new aminoglycoside derivative of kanamycin, a comparison with tobramycin and gentamycin. Antimicrob Agents Chemother. 1973 Apr;3(4):532–533.[PMC free article] [PubMed] [Google Scholar]
  • Simon VK, Mösinger EU, Malerczy V. Pharmacokinetic studies of tobramycin and gentamicin. Antimicrob Agents Chemother. 1973 Apr;3(4):445–450.[PMC free article] [PubMed] [Google Scholar]
Departments of Pediatrics and Obstetrics and Gynecology, and the Hastings Infectious Disease Laboratory, University of Southern California School of Medicine, and the Los Angeles County/University of Southern California Medical Center, Los Angeles, California 90033
Present address: Instituto Nacional de Perinatologia, Vosgos y Montes Urales, Lomas de Chapultepec, Mexico 10, D.F.
Copyright notice
Abstract
To investigate the maternal-fetal transfer of tobramycin (TBM) and its distribution in the fetus, a single dose of 2 mg/kg was administered intramuscularly to 35 pregnant patients (13 first trimester, 22 second trimester) 0.5 to 34 h before hysterectomy. TBM concentration was assayed microbiologically in maternal serum, fetal tissues (placenta, brain, lung, liver, and kidney), and fluids (amniotic, cerebrospinal fluid [CSF], urine, and serum). Mean maternal serum half-life (1.54 h) and mean peak serum concentration of TBM were within ranges reported for nonpregnant adults. In fetal serum, half-life was 5.2 h, and TBM levels did not exceed 0.58 μg/ml. For intervals up to 34 h, the mean TBM concentration in placental tissues was 1.4 μg/g. Concentration differences related to fetal maturation were found for fetal CSF, amniotic fluid, and fetal kidney. No antimicrobial activity was found in the fetal CSF of >16 weeks' gestation. TBM was present predominantly in the second trimester amniotic fluid specimens. Fetal kidney concentrations reached 7.2 μg/g at 34 h after maternal drug administration. Higher TBM concentrations were related to advanced maturation of the fetal kidney. Second trimester fetal urine concentrations for TBM ranged from 0.1 to 3.4 μg/ml, and the fetal urinary half-life was 3.7 h. Knowledge of fetal pharmacology is essential for weighing the fetal benefits or risks of antimicrobial therapy for the infected gravid patient.
Collaboration tool especially designed for Life Science professionals.Drag-and-drop any entity to your messages.