title: Cefazolin pharmacokinetics in maternal plasma and amniotic fluid during pregnancy.
abstract: OBJECTIVE
  To study cefazolin pharmacokinetics in maternal plasma and amniotic fluid during pregnancy.
  
  
  METHODS
  Newly collected time-concentrations profiles and reported studies investigating cefazolin disposition (plasma, amniotic fluid) were pooled. Nonlinear mixed effect modeling was applied. A 2-compartment linear disposition model was used to fit cefazolin plasma observations. A third compartment was used to model amniotic fluid concentration.
  
  
  RESULTS
  One hundred eighty-seven plasma and 96 amniotic fluid samples were collected in 82 pregnancies (17-40 weeks gestational age). Cefazolin clearance and distribution estimates were 7.44 L/h and 12.04 L without gestational age-dependent trends in maternal plasma. The equilibration half-life (T(eq)) between plasma and amniotic fluid at term gestational age was 4.4 hours, increased with decreasing gestational age, and was 9.09 times longer in patients with polyhydramnios.
  
  
  CONCLUSIONS
  Cefazolin clearance and distribution volume are increased during pregnancy. The cefazolin T(eq) depends on gestational age and polyhydramnios. On the basis of these observations, dosing regimes to attain higher amniotic fluid concentrations were formulated.
authors.affiliation: Division of Woman and Child, University Hospitals Leuven, Leuven, Belgium. karel.allegaert@uz.kuleuven.ac.be
authors.forename: Karel
authors.initials: K
authors.lastname: Allegaert
authors.forename: Tim
authors.initials: T
authors.lastname: van Mieghem
authors.forename: Rene
authors.initials: R
authors.lastname: Verbesselt
authors.forename: Jan
authors.initials: J
authors.lastname: de Hoon
authors.forename: Maissa
authors.initials: M
authors.lastname: Rayyan
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
authors.forename: Jan
authors.initials: J
authors.lastname: Deprest
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Anderson
mesh_terms: D000653:Amniotic Fluid / Q000737:chemistry*; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002437:Cefazolin / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D005315:Fetal Diseases / Q000601:surgery; D006801:Humans; D013513:Obstetric Surgical Procedures; D011247:Pregnancy / Q000097:blood*; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin