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Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy: Part I—Penicillins

BACKGROUND AND OBJECTIVE: Pharmacokinetics (PK) are severely altered in pregnant women due to changes in volume of distribution (Vd) and/or drug clearance (CL), affecting target attainment of antibiotics in pregnant women. This review is part of a series that reviews literature on the description of...

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Autores principales: Hesse, M. R., Prins, J. R., Hooge, M. N. Lub-de, Winter, H. L. J., Kosterink, J. G. W., Touw, D. J., Mian, Paola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998600/
https://www.ncbi.nlm.nih.gov/pubmed/36662480
http://dx.doi.org/10.1007/s40262-023-01211-z
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author Hesse, M. R.
Prins, J. R.
Hooge, M. N. Lub-de
Winter, H. L. J.
Kosterink, J. G. W.
Touw, D. J.
Mian, Paola
author_facet Hesse, M. R.
Prins, J. R.
Hooge, M. N. Lub-de
Winter, H. L. J.
Kosterink, J. G. W.
Touw, D. J.
Mian, Paola
author_sort Hesse, M. R.
collection PubMed
description BACKGROUND AND OBJECTIVE: Pharmacokinetics (PK) are severely altered in pregnant women due to changes in volume of distribution (Vd) and/or drug clearance (CL), affecting target attainment of antibiotics in pregnant women. This review is part of a series that reviews literature on the description of PK and target attainment of antibiotics in pregnant women with specific focus on penicillins. METHODS: A systematic literature search was carried out in PubMed. Articles were labelled as relevant when information on PK of penicillins in pregnant women was available. RESULTS: Thirty-two relevant articles were included, 8 of which discussed amoxicillin (with and without clavulanic acid), 15 ampicillin, 4 benzylpenicillin, 1 phenoxymethylpenicillin, and 4 piperacillin (with and without tazobactam). No studies were found on pheneticillin and flucloxacillin in pregnant women. Ten out of 32 articles included information on both Vd and CL. During the second and third trimester of pregnancy, a higher CL and larger Vd was reported than in non-pregnant women and in pregnant women during first trimester. Reduced target attainment was described in second and third trimester pregnant women. Only 7 studies reported dosing advice, 4 of which were for amoxicillin. CONCLUSION: The larger Vd and higher CL in second and third trimester pregnant women might warrant a higher dosage or shortening of the dosing interval of penicillins to increase target attainment. Studies frequently fail to provide dosing advice for pregnant women, even if the necessary PK information was available. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40262-023-01211-z.
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spelling pubmed-99986002023-03-11 Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy: Part I—Penicillins Hesse, M. R. Prins, J. R. Hooge, M. N. Lub-de Winter, H. L. J. Kosterink, J. G. W. Touw, D. J. Mian, Paola Clin Pharmacokinet Systematic Review BACKGROUND AND OBJECTIVE: Pharmacokinetics (PK) are severely altered in pregnant women due to changes in volume of distribution (Vd) and/or drug clearance (CL), affecting target attainment of antibiotics in pregnant women. This review is part of a series that reviews literature on the description of PK and target attainment of antibiotics in pregnant women with specific focus on penicillins. METHODS: A systematic literature search was carried out in PubMed. Articles were labelled as relevant when information on PK of penicillins in pregnant women was available. RESULTS: Thirty-two relevant articles were included, 8 of which discussed amoxicillin (with and without clavulanic acid), 15 ampicillin, 4 benzylpenicillin, 1 phenoxymethylpenicillin, and 4 piperacillin (with and without tazobactam). No studies were found on pheneticillin and flucloxacillin in pregnant women. Ten out of 32 articles included information on both Vd and CL. During the second and third trimester of pregnancy, a higher CL and larger Vd was reported than in non-pregnant women and in pregnant women during first trimester. Reduced target attainment was described in second and third trimester pregnant women. Only 7 studies reported dosing advice, 4 of which were for amoxicillin. CONCLUSION: The larger Vd and higher CL in second and third trimester pregnant women might warrant a higher dosage or shortening of the dosing interval of penicillins to increase target attainment. Studies frequently fail to provide dosing advice for pregnant women, even if the necessary PK information was available. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40262-023-01211-z. Springer International Publishing 2023-01-20 2023 /pmc/articles/PMC9998600/ /pubmed/36662480 http://dx.doi.org/10.1007/s40262-023-01211-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Systematic Review
Hesse, M. R.
Prins, J. R.
Hooge, M. N. Lub-de
Winter, H. L. J.
Kosterink, J. G. W.
Touw, D. J.
Mian, Paola
Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy: Part I—Penicillins
title Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy: Part I—Penicillins
title_full Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy: Part I—Penicillins
title_fullStr Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy: Part I—Penicillins
title_full_unstemmed Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy: Part I—Penicillins
title_short Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy: Part I—Penicillins
title_sort pharmacokinetics and target attainment of antimicrobial drugs throughout pregnancy: part i—penicillins
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998600/
https://www.ncbi.nlm.nih.gov/pubmed/36662480
http://dx.doi.org/10.1007/s40262-023-01211-z
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