Achievement of therapeutic concentrations of cefuroxime in early preterm gestations with premature rupture of the membranes.
OBJECTIVE
To determine whether therapeutic cefuroxime concentrations can be achieved in maternal plasma, amniotic fluid (AF), neonatal plasma, placenta, and membranes in women with premature rupture of the membranes (PROM) at 27-33 weeks' gestation.


METHODS
In an open nonrandomized, dose-response study, nine patients with PROM at 27-33 weeks' gestation received 1.5 g of cefuroxime intravenously three times daily. Maternal plasma and AF specimens were collected during pregnancy, and umbilical cord plasma, placenta, and membrane specimens were collected after delivery to assay cefuroxime concentrations using high-performance liquid chromatography.


RESULTS
A high rate of placental transfer of cefuroxime was found. Bactericidal concentrations could be demonstrated in maternal plasma and in AF leaking from the vagina. A concentration-time curve in AF could be detected, with a peak concentration 3-4 hours after infusion. Therapeutically active levels were present in the newborns. The resorption of cefuroxime by the fetal membranes was high.


CONCLUSIONS
Therapeutic concentrations of cefuroxime were found in all body fluids and tissues studied. Further study to establish the clinical utility of cefuroxime prophylaxis in PROM seems appropriate.
De Leeuw
J W
JW
Department of Obstetrics and Gynecology, St.-Elisabeth Clinic, Heerlen, The Netherlands.
Roumen
F J
FJ
Bouckaert
P X
PX
Cremers
H M
HM
Vree
T B
TB
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry; D002444:Cefuroxime / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D002821:Chorioamnionitis / Q000517:prevention & control; D002851:Chromatography, High Pressure Liquid; D004305:Dose-Response Relationship, Drug; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D002444:Cefuroxime