Amoxicillin pharmacokinetics in pregnant women: Modeling and simulations of dosage strategies
Amoxicillin pharmacokinetics in pregnant women: Modeling and simulations of dosage strategies
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DOI：
10.1038/sj.clpt.6100126
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发表时间：
2007-04-01
影响因子：
6.7
通讯作者：
Hebert, M. F.
中科院分区：
文献类型：
--
作者：
Andrew, M. A.;Easterling, T. R.;Hebert, M. F.
阿莫西林被推荐用于预防怀孕期间的炭疽。本研究的目的是评价阿莫西林在妊娠期和产后（PP）的药代动力学。16名女性在妊娠期间（18-22周（T2）和30-34周（T3））以及产后3个月（PP）接受阿莫西林，以评价单次给药的药代动力学。使用阿莫西林隔室药代动力学参数模拟不同给药策略下的阿莫西林浓度-时间曲线。阿莫西林CL肾（T2：24.8 +/- 6.7 l/ h，P < 0.001; T3：24.0 +/- 3.9 l/h，P < 0.001; PP：15.3 +/- 2.6 l/h）和肾CL分泌（T2：2807 105 ml/ min，P < 0.002; T3：259754 ml/min，P < 0.001; PP：167 +/-47 ml/min），妊娠期高于产后。模拟表明，阿莫西林浓度足以防止炭疽可能难以实现在怀孕期间和产后。阿莫西林CL肾脏和肾脏CL分泌增加反映了肾脏滤过和分泌转运增加或重吸收减少。阿莫西林可能不是炭疽暴露后预防的适当抗生素。
Amoxicillin is recommended for anthrax prevention in pregnancy. The objective of this study was to evaluate the pharmacokinetics of amoxicillin during pregnancy and postpartum ( PP). Sixteen women received amoxicillin during gestation (18-22 weeks (T2) and 30-34 weeks (T3)) as well as 3 months postpartum (PP) to evaluate single-dose pharmacokinetics. Amoxicillin compartmental pharmacokinetic parameters were used to simulate amoxicillin concentration-time profiles following different dosage strategies. Amoxicillin CLrenal (T2: 24.8 +/- 6.7 l/ h, P < 0.001; T3: 24.0 +/- 3.9 l/h, P < 0.001; and PP: 15.3 +/- 2.6 l/h) and renal CLsecretion (T2: 2807105ml/ min, P < 0.002; T3: 259754 ml/min, P < 0.001; and PP: 167 +/- 47ml/min) were higher during pregnancy than postpartum. Simulations suggest that amoxicillin concentrations adequate to prevent anthrax may be difficult to achieve during pregnancy and postpartum. Increases in amoxicillin CLrenal and renal CLsecretion reflect increases in filtration and secretory transport or diminished reabsorption in the kidneys. Amoxicillin may not be an appropriate antibiotic for post-anthrax exposure prophylaxis.