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Vol 83, No 6 (2012)
ARTICLES
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Optimization of antibiotic therapy in pregnancy – clinical implications

Edyta Szałek, Hanna Tomczak, Agnieszka Seremak-Mrozikiewicz, Joanna Bartkowiak-Wieczorek, Edmund Grześkowiak
Ginekol Pol 2012;83(6).

open access

Vol 83, No 6 (2012)
ARTICLES

Abstract

The aim of the antibacterial therapy during pregnancy is to select a proper antibiotic and determine its effective dose, at the same time excluding the risk of potential teratogenic effect. Pregnancy is characterized by many physiological, disease-predisposing changes, particularly of bacterial etiology, that have an influence on different pharmacokinetic of drugs. When determining an effective dose of an antibiotic, one should take into account changes in the pharmacokinetics (PK) of drugs in pregnant women, involving mainly the phase of distribution(increased volume of body fluids, cardiac output, reduced concentration of albumins), metabolism (induction of hepatic enzymes: CYP3A4, CYP2D6, CYP2C9, UGT1A4, UGT2B7, inhibition of CYP1A2, CYP2C19), and excretion (increased glomerular filtration rate). Results of few pharmacokinetic studies on pregnant patients point to the need of increasing the dose or reducing dosage intervals for some antibiotics (e.g. penicillin V, ampicillin, piperacillin, imipenem, clindamycin). The aim of this study was to summarize current knowledge regarding the PK of antibiotics during pregnancy.

Abstract

The aim of the antibacterial therapy during pregnancy is to select a proper antibiotic and determine its effective dose, at the same time excluding the risk of potential teratogenic effect. Pregnancy is characterized by many physiological, disease-predisposing changes, particularly of bacterial etiology, that have an influence on different pharmacokinetic of drugs. When determining an effective dose of an antibiotic, one should take into account changes in the pharmacokinetics (PK) of drugs in pregnant women, involving mainly the phase of distribution(increased volume of body fluids, cardiac output, reduced concentration of albumins), metabolism (induction of hepatic enzymes: CYP3A4, CYP2D6, CYP2C9, UGT1A4, UGT2B7, inhibition of CYP1A2, CYP2C19), and excretion (increased glomerular filtration rate). Results of few pharmacokinetic studies on pregnant patients point to the need of increasing the dose or reducing dosage intervals for some antibiotics (e.g. penicillin V, ampicillin, piperacillin, imipenem, clindamycin). The aim of this study was to summarize current knowledge regarding the PK of antibiotics during pregnancy.
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Keywords

pregnancy, pharmacokinetics, antibiotics

About this article
Title

Optimization of antibiotic therapy in pregnancy – clinical implications

Journal

Ginekologia Polska

Issue

Vol 83, No 6 (2012)

Bibliographic record

Ginekol Pol 2012;83(6).

Keywords

pregnancy
pharmacokinetics
antibiotics

Authors

Edyta Szałek
Hanna Tomczak
Agnieszka Seremak-Mrozikiewicz
Joanna Bartkowiak-Wieczorek
Edmund Grześkowiak

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