Maternal and transplacental pharmacokinetics of cefazolin
Section snippets
Materials and methods
Term patients undergoing scheduled elective cesarean delivery between September 1999 and January 2001 were candidates for the study. Specific inclusion criteria comprised pregnant patients at term who were 18 years of age or older and not in labor. Women who had ruptured membranes, serious maternal illness, signs of infection, or a history of allergy to penicillin or cephalosporin were excluded. Twenty-six patients enrolled in the study. The Institutional Review Board of the University of
Results
Twenty-six women provided informed consent to participate in this investigation. The women ranged in age from 22 to 40 years (31 ± 5 years [mean ± standard deviation]). The gestational age at delivery was 39 ± 1 week (mean ± standard deviation). Of the 26 women, 20 were white, five were black, and one was Asian. The majority of the patients received regional spinal anesthesia (n = 18), whereas the remainder received epidural anesthesia (n = 8). Six underwent a primary cesarean delivery, five
Discussion
The placental transfer of cefazolin appears quite similar to that of ampicillin, with concentrations greater than the MIC90 achieved rapidly in maternal, cord, and AF compartments. This contrasts with the poor or unpredictable delivery of erythromycin and clindamycin to cord blood and AF. The attainment of the MIC90 for cefazolin against group B streptococcus in the body compartments at 4 hours after infusion is compared with that of other recommended antimicrobial agents for group B
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