Placental passage of clarithromycin surpasses other macrolide antibiotics
Objective: Infection of the amnion cavity with Ureaplasma urealyticum continues to be a therapeutic challenge. The transplacental transfer rates of macrolide antibiotics are low, and tetracyclines and quinolones are contraindicated in pregnancy. The aim of this study was to investigate placental tra...
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Published in | American journal of obstetrics and gynecology Vol. 188; no. 3; pp. 816 - 819 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Philadelphia, PA
Mosby, Inc
01.03.2003
Elsevier |
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Abstract | Objective: Infection of the amnion cavity with Ureaplasma urealyticum continues to be a therapeutic challenge. The transplacental transfer rates of macrolide antibiotics are low, and tetracyclines and quinolones are contraindicated in pregnancy. The aim of this study was to investigate placental transfer of clarithromycin in a well-studied placental perfusion model to determine whether clarithromycin surpasses the transfer rate of other macrolide antibiotics in similar models. Study Design: Ten placentas that were obtained immediately after delivery were perfused with clarithromycin (3 μg/mL) plus a reference substance (antipyrine). Open circulation placental preparations were used to evaluate steady-state pharmacodynamics and transplacental gradient formation. Drug concentrations were measured by high-performance liquid chromatography. Results: The mean transplacental transfer of clarithromycin was 6.1% (95% CI, 1.8%). Conclusion: Because of its enhanced placental passage compared with other macrolide antibiotics, clarithromycin that is given after the first trimester (after embryogenesis) may be an appropriate candidate in treatment trials of genital mycoplasma and ureaplasma infections during pregnancy. (Am J Obstet Gynecol 2003;188:816-9.) |
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AbstractList | Infection of the amnion cavity with Ureaplasma urealyticum continues to be a therapeutic challenge. The transplacental transfer rates of macrolide antibiotics are low, and tetracyclines and quinolones are contraindicated in pregnancy. The aim of this study was to investigate placental transfer of clarithromycin in a well-studied placental perfusion model to determine whether clarithromycin surpasses the transfer rate of other macrolide antibiotics in similar models.
Ten placentas that were obtained immediately after delivery were perfused with clarithromycin (3 microg/mL) plus a reference substance (antipyrine). Open circulation placental preparations were used to evaluate steady-state pharmacodynamics and transplacental gradient formation. Drug concentrations were measured by high-performance liquid chromatography.
The mean transplacental transfer of clarithromycin was 6.1% (95% CI, 1.8%).
Because of its enhanced placental passage compared with other macrolide antibiotics, clarithromycin that is given after the first trimester (after embryogenesis) may be an appropriate candidate in treatment trials of genital mycoplasma and ureaplasma infections during pregnancy. OBJECTIVEInfection of the amnion cavity with Ureaplasma urealyticum continues to be a therapeutic challenge. The transplacental transfer rates of macrolide antibiotics are low, and tetracyclines and quinolones are contraindicated in pregnancy. The aim of this study was to investigate placental transfer of clarithromycin in a well-studied placental perfusion model to determine whether clarithromycin surpasses the transfer rate of other macrolide antibiotics in similar models.STUDY DESIGNTen placentas that were obtained immediately after delivery were perfused with clarithromycin (3 microg/mL) plus a reference substance (antipyrine). Open circulation placental preparations were used to evaluate steady-state pharmacodynamics and transplacental gradient formation. Drug concentrations were measured by high-performance liquid chromatography.RESULTSThe mean transplacental transfer of clarithromycin was 6.1% (95% CI, 1.8%).CONCLUSIONBecause of its enhanced placental passage compared with other macrolide antibiotics, clarithromycin that is given after the first trimester (after embryogenesis) may be an appropriate candidate in treatment trials of genital mycoplasma and ureaplasma infections during pregnancy. Objective: Infection of the amnion cavity with Ureaplasma urealyticum continues to be a therapeutic challenge. The transplacental transfer rates of macrolide antibiotics are low, and tetracyclines and quinolones are contraindicated in pregnancy. The aim of this study was to investigate placental transfer of clarithromycin in a well-studied placental perfusion model to determine whether clarithromycin surpasses the transfer rate of other macrolide antibiotics in similar models. Study Design: Ten placentas that were obtained immediately after delivery were perfused with clarithromycin (3 μg/mL) plus a reference substance (antipyrine). Open circulation placental preparations were used to evaluate steady-state pharmacodynamics and transplacental gradient formation. Drug concentrations were measured by high-performance liquid chromatography. Results: The mean transplacental transfer of clarithromycin was 6.1% (95% CI, 1.8%). Conclusion: Because of its enhanced placental passage compared with other macrolide antibiotics, clarithromycin that is given after the first trimester (after embryogenesis) may be an appropriate candidate in treatment trials of genital mycoplasma and ureaplasma infections during pregnancy. (Am J Obstet Gynecol 2003;188:816-9.) |
Author | Postlbauer, Karl Witt, Armin Widhalm, Alexander Reisenberger, Klaus Cichna, Margit Sommer, Eva Maria Gregor, Hubertus |
Author_xml | – sequence: 1 givenname: Armin surname: Witt fullname: Witt, Armin organization: Department of Obstetrics and Fetomaternal Medicine, University of Vienna Medical School Vienna, Austria – sequence: 2 givenname: Eva Maria surname: Sommer fullname: Sommer, Eva Maria organization: Department of Obstetrics and Gynecology, General Hospital Wels Vienna, Austria – sequence: 3 givenname: Margit surname: Cichna fullname: Cichna, Margit organization: Institute of Analytical Chemistry, University of Vienna Vienna, Austria – sequence: 4 givenname: Karl surname: Postlbauer fullname: Postlbauer, Karl organization: Department of Obstetrics and Fetomaternal Medicine, University of Vienna Medical School Vienna, Austria – sequence: 5 givenname: Alexander surname: Widhalm fullname: Widhalm, Alexander organization: Department of Obstetrics and Fetomaternal Medicine, University of Vienna Medical School Vienna, Austria – sequence: 6 givenname: Hubertus surname: Gregor fullname: Gregor, Hubertus organization: Department of Prenatal Diagnosis and Therapy, University of Vienna Medical School. Vienna, Austria – sequence: 7 givenname: Klaus surname: Reisenberger fullname: Reisenberger, Klaus organization: Department of Obstetrics and Gynecology, General Hospital Wels Vienna, Austria |
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Keywords | ureaplasma perfusion model Clarithromycin placental passage mycoplasma macrolide Human Placental transfer Clearance Experimental study In vitro Macrolide ureaplasma,mycoplasma Antibiotic Placenta Perfusion Female Antibacterial agent |
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Snippet | Objective: Infection of the amnion cavity with Ureaplasma urealyticum continues to be a therapeutic challenge. The transplacental transfer rates of macrolide... Infection of the amnion cavity with Ureaplasma urealyticum continues to be a therapeutic challenge. The transplacental transfer rates of macrolide antibiotics... OBJECTIVEInfection of the amnion cavity with Ureaplasma urealyticum continues to be a therapeutic challenge. The transplacental transfer rates of macrolide... |
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SubjectTerms | Anti-Bacterial Agents - pharmacokinetics Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Chromatography, High Pressure Liquid Clarithromycin Clarithromycin - pharmacokinetics Diseases of mother, fetus and pregnancy Female Gynecology. Andrology. Obstetrics Homeostasis Humans macrolide Medical sciences mycoplasma perfusion model Pharmacology. Drug treatments Placenta - metabolism placental passage Pregnancy Pregnancy. Fetus. Placenta ureaplasma |
Title | Placental passage of clarithromycin surpasses other macrolide antibiotics |
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