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Review of β-Lactam Antibiotics in Pregnancy

The Need for Adjustment of Dosage Schedules

  • Review Article
  • Clinical Pharmacokinetics in Special Populations
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Summary

β-Lactam antibiotics represent the oldest class of antibiotics used in the treatment of infections, and benzylpenicillin (penicillin G) is still the most commonly used antibiotic agent during pregnancy. There is a number of studies to suggest that the pharmacokinetics of β-lactam antibiotics are altered during pregnancy, indicating faster elimination of these antibiotics and lowered plasma concentrations. These changes are largely related to the physiological changes taking place in the maternal body. Generally, drugs are used cautiously during pregnancy, and dosages used may sometimes be inadequate. With regards to antibiotic agents, assurance of adequate therapy by applying pharmacokinetic knowledge when dosage schedules are designed should be a major concern so that the pregnancy is protected from the hazards of infection.

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References

  1. Heikkilä A. Antibiotics in pregnancy — a prospective cohort study on the prescription of antibiotics during pregnancy. Ann Med 1993; 25(5): 467–71

    Article  PubMed  Google Scholar 

  2. Holme E, Greter J, Jacobson C-E, et al. Carnitine deficiency induced by pivampicillin and pivmecillinam therapy. Lancet 1989; 2: 469–73

    Article  PubMed  CAS  Google Scholar 

  3. Rebouche CJ, Engel AG. Carnitine metabolism and deficiency syndromes. Mayo Clin Proc 1983; 58: 533–40

    PubMed  CAS  Google Scholar 

  4. Nora JJ, Nora AH, Sommerville RJ, et al. Maternal exposure to potential teratogens. JAMA 1967; 202: 1065–9

    Article  PubMed  CAS  Google Scholar 

  5. Nelson MM, Forfar JO. Associations between drugs administered during pregnancy and congenital abnormalities of the fetus. BMJ 1971; 1: 523–7

    Article  PubMed  CAS  Google Scholar 

  6. Aavitsland P. Survey of the treatment of chlamydia trachomatis infection of the female genital tract. Acta Obstet Gynecol Scand 1992; 71: 356–9

    Article  PubMed  CAS  Google Scholar 

  7. Jones HM, Cummings AJ. A study of the transfer of alfamethyldopa to the human foetus and newborn infant. Br J Clin Pharmacol 1978; 6: 432–4

    Article  PubMed  CAS  Google Scholar 

  8. Knott C, Williams CP, Reynolds F. Phenytoin kinetics during pregnancy and the puerperium. Br J Obstet Gynaecol 1986; 93: 1030–7

    Article  PubMed  CAS  Google Scholar 

  9. Kyegombe D, Franklin C, Turner P. Drug-metabolising enzymes in the human placenta, their induction and repression. Lancet 1973; 1: 405–6

    Article  PubMed  CAS  Google Scholar 

  10. Pelkonen O. Xenobiotic metabolism in the maternal-placental-fetal unit: implications for fetal toxicity. Developmental Pharmacol Ther 1984; 1 Suppl. 7: 11–17

    Google Scholar 

  11. Zak O, O’Reilly T. Animal models as predictors of the safety and efficacy of antibiotics. Eur J Clin Microbiol Infect Dis 1990; 9: 472–7

    Article  PubMed  CAS  Google Scholar 

  12. Krauer B, Krauer F. Drug kinetics in pregnancy. Clin Pharmacokinet 1977; 2: 167–81

    Article  PubMed  CAS  Google Scholar 

  13. Robertson EG. Physiologic adjustment in pregnancy: water metabolism. Clin Obstet Gynecol 1975; 2: 431–40

    Google Scholar 

  14. Gravett LG, Hummel D, Eschenbach DA, et al. Preterm labor associated with subclinical amniotic fluid infection and with bacterial vaginosis. Obstet Gynecol 1986; 67: 229–37

    Article  PubMed  CAS  Google Scholar 

  15. Hameed C, Tejani N, Verma UL, et al. Silent chorioamnionitis as a sign of preterm labor refractory to tocolytic therapy. Am J Obstet Gynecol 1984; 149: 726–30

    PubMed  CAS  Google Scholar 

  16. Lamont RF, Taylor-Robinson D, Newman M, et al. Spontaneous early preterm labor associated with abnormal genital bacterial colonization. Br J Obstet Gynaecol 1986; 93: 804–10

    Article  PubMed  CAS  Google Scholar 

  17. Romero R, Mazor M, Oyarzun E, Sirtori M, et al. Is genital colonization with Mycoplasma hominis or Ureaplasma urealyticum associated with prematurity low birth weight? Obstet Gynecol 1989; 73: 532–6

    PubMed  CAS  Google Scholar 

  18. Bobitt JR, Ledger WJ. Unrecognized amnionitis in prematurity. A preliminary report. J Reprod Med 1977; 19: 8–12

    PubMed  CAS  Google Scholar 

  19. Bobitt JR, Hayslip CC, Damato JD. Amniotic fluid infection as determined by transabdominal amniocentesis in patients with intact membranes in labor. Am J Obstet Gynecol 1981; 140: 947–52

    PubMed  CAS  Google Scholar 

  20. Hobel CJ. Clinical aspects of infections as a cause of prematurity: ‘a continuum of risk’. In: Saling E, editor. Perinatology. New York: Raven Press, 1992: 111–25

    Google Scholar 

  21. Miller JM, Pupkin MJ, Hill GP. Bacterial colonization of amniotic fluid from intact fetal membranes. Am J Obstet Gynecol 1980; 136: 796–804

    PubMed  Google Scholar 

  22. Wahbeh CJ, Hill GB, Eden RD, et al. Intra-amniotic bacterial colonization in premature labor. Am J Obstet Gynecol 1984; 148: 739–43

    PubMed  CAS  Google Scholar 

  23. Duff P. Pyelonephritis in pregnancy. Clin Obstet Gynecol 1984; 27: 17–31

    Article  PubMed  CAS  Google Scholar 

  24. Kass EH. How important is bacteriuria? Rev Infect Dis 1982; 4: 434–7

    Article  PubMed  CAS  Google Scholar 

  25. Waltzer WC. The urinary tract in pregnancy. J Urol 1981; 125: 271–6

    PubMed  CAS  Google Scholar 

  26. Gilstrap LC, Leveno KJ, Cunningham FG, et al. Renal infection and pregnancy outcome. Am J Obstet Gynecol 1981; 141: 709–16

    PubMed  CAS  Google Scholar 

  27. Naeye RL, Peters EC. Causes and consequences of premature rupture of fetal membranes. Lancet 1980; 1: 192–4

    Article  PubMed  CAS  Google Scholar 

  28. Diem K, Lentner C, editors. Wissenschaftliche Tabellen, Dokumenta Geigy. 7th ed. Stuttgart: Georg Thieme Verlag, 1975: 798

    Google Scholar 

  29. Duncan S, Lewis BV. Maternal placental and myometrial blood flow in the pregnant rabbit. J Physiol 1969; 202: 471–81

    PubMed  CAS  Google Scholar 

  30. Bartels H, Moll W, Metcalfe J. Physiology of gas exchange in the human placenta. Am J Obstet Gynecol 1962; 84: 1714–30

    PubMed  CAS  Google Scholar 

  31. Stulc J. Is there control of solute transport at placental level? Placenta 1988; 9: 19–26

    Article  PubMed  CAS  Google Scholar 

  32. Reynolds ML, Young M. The transfer of free alfa-amino nitrogen across the placental membrane in the guinea pig. J Physiol 1971; 214: 583–97

    PubMed  CAS  Google Scholar 

  33. Elek E, Ivan E, Arr M. Passage of penicillins from mother to foetus in humans. Int J Clin Pharmacol 1972; 6: 223–8

    PubMed  CAS  Google Scholar 

  34. Kauffman RE, Boulos BM, Azarnoff DL. Placental transfer of penicillin G during constant-rate infusion in the goat. Am J Obstet Gynecol 1973; 117: 64–8

    PubMed  CAS  Google Scholar 

  35. Wasz-Höckert O, Nummi S, Vuopala S, et al. Transplacental passage of azidocillin, ampicillin and penicillin during early and late pregnancy. Scand J Infect Dis 1970; 2: 125–30

    PubMed  Google Scholar 

  36. Woltz JHE, Wiley MM. The transmission of penicillin to the previable fetus. JAMA 1946; 131: 969–70

    Article  CAS  Google Scholar 

  37. Adamkin DH, Marshall E, Weiner LB. The placental transfer of ampicillin. Am J Perinatol 1984; 1: 310–11

    Article  PubMed  CAS  Google Scholar 

  38. Bastert G, Wallhauser K, Wernicke K, et al. Pharmakokinetische untersuchungen zum ubertritt von antibiotika in das fruchtwasser am ende der Schwangerschaft. 1. Teil: ampicillin. Z Geburtshilfe Perinatol 1973; 178: 164–73

    Google Scholar 

  39. Boreus L-O. Placental transfer of ampicillin in man. Acta Pharm Toxicol 1971; 3 Suppl.: 250–4

    Google Scholar 

  40. Bray RE, Boe RW, Johnson WL. Transfer of ampicillin into fetus and amniotic fluid from maternal plasma in late pregnancy. Am J Obstet Gynecol 1966; 96: 938–42

    PubMed  CAS  Google Scholar 

  41. MacAulay MA, Abou-Sabe M, Charles D. Placental transfer of ampicillin. Am J Obstet Gynecol 1966; 96: 943–50

    PubMed  CAS  Google Scholar 

  42. Perry JE, Leblanc AL. Transfer of ampicillin across the human placenta. Tex Rep Biol Med 1967; 25: 547–51

    PubMed  CAS  Google Scholar 

  43. Bernard B, Barton L, Abate M, et al. Maternal-fetal transfer of cefazolin in the first twenty weeks of pregnancy. J Infect Dis 1977; 136: 377–82

    Article  PubMed  CAS  Google Scholar 

  44. Jorgensen NP, Walstad RA, Moine K. The concentrations of ceftazidime and thiopental in maternal plasma, placental tissue and amniotic fluid in early pregnancy. Acta Obstet Gynecol Scand 1987; 66: 29–33

    Article  PubMed  CAS  Google Scholar 

  45. Matsuda S, Fujii R. Pharmacokinetic and clinical studies of ceftizoxime in the perinatal period. Int J Feto-Maternal Med 1991; 4: 1–7

    Google Scholar 

  46. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility tests. M2-A4. NCCLS. Philadelphia: Villanova, 1990

    Google Scholar 

  47. Kafetzis DA, Brater CD, Fanourgakis JE, et al. Ceftriaxone distribution between maternal blood and fetal blood and tissues at parturition and between blood and milk postpartum. Antimicrob Agents Chemother 1983; 23: 870–3

    Article  PubMed  CAS  Google Scholar 

  48. Lang R, Shalit I, Segal J. Maternal and fetal serum and tissue levels of ceftriaxone following preoperative prophylaxis in emergency caesarean section. Chemotherapy 1993; 39: 77–81

    Article  PubMed  CAS  Google Scholar 

  49. Craft I, Mullinger BM, Kennedy MRK. Placental transfer of cefuroxime. Br J Obstet Gynaecol 1981; 88: 141–5

    Article  PubMed  CAS  Google Scholar 

  50. Philipson A, Stiernstedt G. Pharmacokinetics of cefuroxime in pregnancy. Am J Obstet Gynecol 1982; 142: 823–8

    PubMed  CAS  Google Scholar 

  51. deLeeuw J, Roumen F, Bouckaert P, et al. Achievement of therapeutic concentrations of cefuroxime in early preterm gestations with premature rupture of the membranes. Obstet Gynecol 1993; 81: 255–60

    CAS  Google Scholar 

  52. Duval J, Mora M, Chartier M, et al. La cephalexine. Son transfer placentaire. Nouv Pr Medic 1972; 1: 1419–20

    CAS  Google Scholar 

  53. Barr W, Graham R. Placental transmission of cephaloridine. Postgrad Med J 1967; 43 Suppl.: 101–4

    PubMed  CAS  Google Scholar 

  54. MacAulay MA, Charles D. Placental transfer of cephalothin. Am J Obstet Gynecol 1968; 100: 940–6

    PubMed  CAS  Google Scholar 

  55. Morrow S, Palmisano P, Cassady G. The placental transfer of cephalothin. J Pediatr 1968; 73: 262–4

    Article  PubMed  CAS  Google Scholar 

  56. Paterson L, Henderson A, Burnett Lunan C, et al. Transfer of cephalothin sodium to the fetus. J Obstet Gynaecol Br Commonwealth 1970; 77: 565–6

    Article  CAS  Google Scholar 

  57. Bergogne-Berezin E, Lambert-Zechovsky M, Rouvillois JL. Pharmacocinetique d’une nouvelle Cephalosporine, la cephradine. Interet de l’etude de son passage transplacentaire. Med Mal Infect 1975; 8: 426–31

    Article  Google Scholar 

  58. Craft I, Forster TC: Materno-fetal cepharadine transfer in pregnancy. Antimicrob Agents Chemother 1978; 14: 924–6

    Article  PubMed  CAS  Google Scholar 

  59. Lange CR. The transfer of cephradine across the placenta. Br J Obstet Gynaecol 1984; 91: 551–4

    Article  PubMed  CAS  Google Scholar 

  60. MacAulay MA, Berg SR, Charles D. Placental transfer of dicloxacillin at term. Am J Obstet Gynecol 1968; 102: 1162–8

    PubMed  CAS  Google Scholar 

  61. Depp R, Kind AC, Kirby WMM, et al. Transplacental passage of methicillin and dicloxacillin into the fetus and amniotic fluid. Am J Obstet Gynecol 1970; 107: 1054–7

    PubMed  CAS  Google Scholar 

  62. Heikkilä A, Renkonen O-V, Erkkola R. Pharmacokinetics and transplacental passage of imipenem during pregnancy. Antimicrob Agents Chemother 1992a; 36: 2652–5

    Article  PubMed  Google Scholar 

  63. Heikkilä A, Pyykkö K, Erkkola R, et al. The pharmacokinetics of mecillinam and pivmecillinam in pregnant and non-pregnant women. Br J Clin Pharmacol 1992b; 33: 629–33

    Article  PubMed  Google Scholar 

  64. MacAulay MA, Molloy WB, Charles D. Placental transfer of methicillin. Am J Obstet Gynecol 1973; 115: 58–65

    PubMed  CAS  Google Scholar 

  65. Akbaraly JP, Guibert S, Leng JJ, et al. Etude du passage transplacentaire de cinq antibiotiques par perfusion in vitro du placenta humain. Pathol Biol 1985; 33: 368–72

    PubMed  CAS  Google Scholar 

  66. Heikkilä A, Erkkola R. Pharmacokinetics of piperacillin during pregnancy. J Antimicrob Chemother 1991; 28: 419–23

    Article  PubMed  Google Scholar 

  67. Iwasaki T, Machihara M. Fundamental studies of transferred concentration fof piperacillin into maternal serum, umbilical cord serum and amniotic fluid. Jpn J Antibiot 1982; 35: 2206–12

    PubMed  CAS  Google Scholar 

  68. Matsuda S, Kashiwakura T, Suzuki M, et al. CLinical and laboratory evaluations of ceftazidime in perinatal use. A study of ceftazidime in the perinatal co-research group. Japanese Journal of Antibiotics 1986; 39: 2199–213

    PubMed  CAS  Google Scholar 

  69. Brown CE, Chritmas JT, Bawdon RE. Placental transfer of cefazolin and piperacillin in pregnancies remote from term complicated by Rh isoimmunization. Am J Obstet Gynecol 1990; 163: 938–43

    PubMed  CAS  Google Scholar 

  70. Drusano GL. Role of pharmacokinetics in the outcome of infections. Antimicrob Agents Chemother 1988; 32: 289–97

    Article  PubMed  CAS  Google Scholar 

  71. Vogelman B, Craig WA. Kinetics of antimicrobial activity. J Pediatr 1986; 108: 835–40

    Article  PubMed  CAS  Google Scholar 

  72. Gudmundsson WA, Vogelman B, Craig WA. The in vivo postantibiotic effect of imipenem and other new antimicrobials. J Antimicrob Chemother 1986; 15 Suppl. A: 67–73

    Google Scholar 

  73. Schentag JJ, Smith IL, Swanson DJ, et al. Role for dual individualization with cefmenoxime. Am J Med 1984; 77 Suppl. 6A: 43–50

    PubMed  CAS  Google Scholar 

  74. Schentag JJ, Swanson DJ, Smith IL. Dual individualization — antibiotic dosage calculation forms the intergration of in vitro pharmacodynamics and in vivo pharmacokinetics. J Antimicrob Chemother 1985; 15 Suppl. A: 47–57

    PubMed  CAS  Google Scholar 

  75. Bergan T. Pharmacokinetics of tissue penetration of antibiotics. Rev Infect Dis 1981; 3: 45–66

    Article  PubMed  CAS  Google Scholar 

  76. Barza M. Principles of tissue penetration of antibiotics. J Antimicrob Chemother 1981; 8 Suppl. 6: 7–28

    PubMed  CAS  Google Scholar 

  77. Schentag JJ. Clinical significance of antibiotic tissue penetrations. Clin Pharmacokinet 1989; 16 Suppl. 1: 25–31

    Article  PubMed  CAS  Google Scholar 

  78. Cars O. Pharmacokinetics of antibiotics in tissues and tissue fluids: a review. Scand J Infect Dis 1991; 74 Suppl.: 23–33

    Google Scholar 

  79. Barbhaiya RH, Shukla UA, Gleason CR, et al. Comparison of cefprozil and cefaclor pharmacokinetics and tissue penetration. Antimicrob Agents Chemother 1990; 34: 1204–9

    Article  PubMed  CAS  Google Scholar 

  80. Moore RD, Lietman PS, Smith CR. Clinical response to aminoglycoside therapy: importance of the ratio of peak concentration to MIC. J Infect Dis 1987; 155: 93–9

    Article  PubMed  CAS  Google Scholar 

  81. Craig WA, Welling PG. Protein binding of antimicrobials: clinical pharmacokinetic and therapeutic implications. Clin Pharmacokinet 1977; 2: 252–68

    Article  PubMed  CAS  Google Scholar 

  82. Wise R, Gillet AP, Cadge B, et al. The influence of protein binding upon tissue fluid levels of six beta-lactams. J Infect Dis 1980; 142: 77–82

    Article  PubMed  CAS  Google Scholar 

  83. Drusano GL, Standiford HC, Bustamante C, et al. Multiple-dose pharmacokinetics of imipenem/cilastatin (MK-787/MK-791). Antimicrob Agents Chemother 1984; 26: 715–21

    Article  PubMed  CAS  Google Scholar 

  84. Reitberg DP, Cumbo TJ, Smith IL, et al. Effect of protein binding on cefmenoxime steady state kinetics in critical care patients. Clin Pharmacol Ther 1984; 35: 64–73

    Article  PubMed  CAS  Google Scholar 

  85. Popick A, Crouthamel W, Bekersky I. Plasma protein binding of ceftriaxone. Xenobiotica 1987; 17: 1139–45

    Article  PubMed  CAS  Google Scholar 

  86. Hayton W, Stoeckel K. Age-associated changes in ceftiaxone pharmacokinetics. Clin Pharmacokinet 1986; 11: 76–86

    Article  PubMed  CAS  Google Scholar 

  87. Shyu WC, Quintiliani R, Nightingale CH, et al. Effect of protein binding on drug penetration into blister fluid. Antimicrob Agents Chemother 1988; 32: 128–30

    Article  PubMed  CAS  Google Scholar 

  88. Dudley MN, Blaser J, Gilbert D, et al. Significance of ‘extravascular’ protein binding for antimicrobial pharmacodynamics in an in vitro capillary mode of infection. Antimicrob Agents Chemother 1990; 34: 98–101

    Article  PubMed  CAS  Google Scholar 

  89. Bergan T. Pharmacokinetics of beta-lactam antibiotics. Scand J Infect Dis 1984; 42 Suppl.: 83–98

    CAS  Google Scholar 

  90. Moffat JA, Milne B. Pharmacokinetics in anesthesia. Can Anaesth Soc J 1983; 30: 300–7

    Article  PubMed  CAS  Google Scholar 

  91. Morita E, Mizuno N, Nishikata M, et al. Effect of gastrointestinal maturation on absorption of beta-lactam antibiotics. J Pharm Sci 1992; 81: 337–40

    Article  PubMed  CAS  Google Scholar 

  92. Oguma T, Yamada H, Sawaki M, et al. Pharmacokinetic analysis of the effects of different foods on absorption of cefaclor. Antimicrob Agents Chemother 1991; 35: 1729–35

    Article  PubMed  CAS  Google Scholar 

  93. Parry E, Shields R, Turnbull A. Transit time in the small intestine in pregnancy. J Obstet Gynaecol Br Comm 1970; 77: 900–901

    Article  CAS  Google Scholar 

  94. Nimmo WS. Drugs, diseases and altered gastric emptying. Clin Pharmacokinet 1976; 1: 189–203

    Article  PubMed  CAS  Google Scholar 

  95. Clements J, Heading R, Nimmo W, et al. Kinetics of acetaminophen absorption and gastric emptying. Clin Pharmacol Ther 1978; 24: 420–31

    PubMed  CAS  Google Scholar 

  96. Philipson A. Pharmacokinetics of ampicillin during pregnancy. J Infect Dis 1977; 136: 370–6

    Article  PubMed  CAS  Google Scholar 

  97. Heikkilä A, Erkkola R. The need for adjustment of dosage regimen for penicillin V during pregnancy. Obstet Gynecol 1993; 81(6): 919–21

    PubMed  Google Scholar 

  98. Philipson A. Plasma levels of ampicillin in pregnant women following administration of ampicillin and pivampicillin. Am J Obstet Gynecol 1978; 130: 674–83

    PubMed  CAS  Google Scholar 

  99. Voigt R, Schroder S, Meinhold P, et al. Klinische Untersuchungen zum einfluss von Schwangerschaft und geburt auf die Pharmakokinetik von ampizillin. Zentralbl Gynakol 1978; 100: 701–5

    PubMed  CAS  Google Scholar 

  100. Kubacka R, Johnstone H, Tan H, et al. Intravenous ampicillin pharmacokinetics in the third trimester of pregnancy. Ther Drug Monit 1983; 5: 55–60

    Article  PubMed  CAS  Google Scholar 

  101. Kjer J, Ottesen B. Pharmacokinetics of pivmecillinam hydrochloride in pregnant and non-pregnant women. Acta Pharmac Tox 1986; 59: 430–1

    Article  CAS  Google Scholar 

  102. Voigt R, Schroder S, Peiker G. Pharmacokinetic studies of azlocillin and piperacillin during late pregnancy. Chemother 1985; 31: 417–24

    Article  CAS  Google Scholar 

  103. Martens MG, Faro S, Feldman S, et al. Pharmacokinetics of the acyclureidopenicillins piperacillin and mezlocillin in the postpartum patient. Antimicrob Agents Chemother 1987; 31: 2015–7

    Article  PubMed  CAS  Google Scholar 

  104. Charles O, Larsen B. Pharmacokinetics of piperacillin in the postpartum patient. Gynecol Obstet Invest 1985; 20: 194–8

    Article  PubMed  CAS  Google Scholar 

  105. Begue P, Quinet B, Baron S, et al. Clinical and pharmacokinetic study of imipenem/cilastatin in children and newborn infants. Pathol Biol 1989; 5: 485–90

    Google Scholar 

  106. Cho N, Fukunaga K, Kunii K, et al. Studies on imipenem/cilastatin sodium in the perinatal period. Jpn J Antibiot 1988; 11: 1758–73

    Google Scholar 

  107. Walter A, Heilmeyer L. Antibiotika-Fibel. 4. Auflage. Stuttgart: Georg Thieme Verlag, 1975

    Google Scholar 

  108. Bastert G, Wernicke K, Muller W-G, et al. Pharmakokinetische untersuchungen zum ubertritt von antibiotika in das fruchtwasser am ende der Schwangerschaft. 2. Teil: cephalothin. Z Geburtshilfe Perinatol 1974; 178: 164–72

    PubMed  CAS  Google Scholar 

  109. Gonik B, Cotton D, Feldman S, et al. Comparative pharmacokinetics of cefoxitin in the postpartum normotensive and pregnancy-induced hypertensive patient. Am J Obstet Gynecol 1984; 148: 1088

    PubMed  CAS  Google Scholar 

  110. Roex A, vanLoenen A, Puyenbroek J, et al. Secretion of cefoxitin in breast milk following short-term prophylactic administration in caesarean section. Eur J Obstet Gynecol Reprod Biol 1987; 25: 299–302

    Article  PubMed  CAS  Google Scholar 

  111. Gonik B, Cotton D, Feldman S, et al. Pharmacokinetics of cefotaxime in the postpartum patient. Am J Perinatol 1985; 2: 114–7

    Article  PubMed  CAS  Google Scholar 

  112. Fu K, Aswapokee P, Ho I, et al. Pharmacokinetics of cefotaxime. Antimicrob Agents Chemother 1979; 16: 592

    Article  PubMed  CAS  Google Scholar 

  113. Arthur L, Burand W. Transfer of cephaloridine from mother to fetus. Arch Dis Child 1969; 44: 82–3

    Article  PubMed  CAS  Google Scholar 

  114. Kimmerich B, Lode H, Belmega T, et al. Comparative pharmacokinetics of cefoperazone, cefotaxime, and moxalactam. Antimicrob Agents Chemother 1983; 23: 429–34

    Article  Google Scholar 

  115. Gonik B, Feldman S, Pickering L, et al. Pharmacokinetics of cefoperazone in the parturient. Antimicrob Agents Chemother 1986; 30: 874–6

    Article  PubMed  CAS  Google Scholar 

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Heikkilä, A., Erkkola, R. Review of β-Lactam Antibiotics in Pregnancy. Clin. Pharmacokinet. 27, 49–62 (1994). https://doi.org/10.2165/00003088-199427010-00005

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