450: Transplacental transfer of ceftriaxone in pregnant women with preterm premature rupture of membranes

Abstract

The administrations of antibiotics to preterm premature rupture of membrane (PPROM) patients are standard treatment to prolong latency period and to prevent or treat infection. Ceftriaxone is one of the commonly used antibiotics for this purpose. However, pharmacokinetic study of antibiotics are sparse. The purpose of this study is to evaluate the transplacental transfer of ceftriaxone. Singleton pregnant women with PPROM were prospectively enrolled between August 2012 and April 2014. The diagnosis of PPROM was made with vaginal pooling or leakage of amniotic fluid or nitrazine test or amnisure test. After diagnosis of PPROM women were managed with triple antibiotics (ceftriaxone, clarithromycin, metronidazole). Both maternal and cord blood were obtained immediately at the time of delivery and stored at -70 °C deep freezer. Ceftriaxone concentration was measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). A total of 31 cord-maternal serum pairs were available for analysis. The median umbilical cord and maternal serum concentrations were 6142 ng/mL and 6451 ng/mL, respectively. The median cord to maternal ratio of ceftriaxone was 0.97 (interquartile range 0.76-1.39). There was good correlation between cord and maternal serum ceftriaxone (Fig1, r=0.584, p< 0.01). There was a decreasing tendency of cord serum ceftriaxone as the hours from last injection of ceftriaxone to delivery increased (Fig2, r =-0.501, p< 0.01). The cord blood concentration of ceftriaxone was approximately 97% of maternal serum concentration and decreased as the hours from last injection of ceftriaxone to delivery increased.View Large Image Figure ViewerDownload Hi-res image Download (PPT)