Transfer of Timentin (ticarcillin and clavulanic acid) across the in vitro perfused human placenta: Comparison with other agents

Abstract

OBJECTIVES: In vitro perfusion of human placentas was used to quantify the net placental transfer of ticarcillin and clavulanic acid.STUDY DESIGN: Placentas were obtained from uncomplicated pregnancies at term. The maternal and fetal circulations were reestablished at flow rates of 17.5 ml/min and 5 ml/min, respectively. Open circulations were used to evaluate steady-state pharmacodynamics and transplacental gradient formation. Drug levels were measured by high-pressure liquid chromatography.RESULTS: The clearance index of ticarcillin was 0.037 ± 0.004. The fetal/maternal ratio was 0.91. Therapeutic concentrations of clavulanate (2 to 6 11g/ml) in the maternal media resulted in undetectable transfer to the fetal compartment. By using higher levels of clavulanate, a clearance index of 0.061 ± 0.001 (mean ± SEM) and 1 : 1 fetal/maternal gradient was obtained.CONCLUSIONS: These data correspond to relatively low transfer of ticarcillin with a cord/maternal ratio of \\lt 1. Clavulanate transfer is slightly greater. Agents with similar acitvity and superior transfer would optimize intrauterine treatment. (AM J OBSTET GYNECOL 1992;167:1595-9.)