Fundamental and clinical studies of cefotaxime during the perinatal period in pregnant women

: Fundamental and clinical studies of cefotaxime (CTX) were carried out in pregnant women. The following results were obtained. CTX was more rapidly eliminated from the serum of pregnant women than that of adult males. Urinary excretion of CTX in pregnant women was comparable to that in nonpregnant women and adult males. Passage of CTX to the embryo, fetus and fetal appendages was minimal. Peak amniotic fluid concentration (9.8 mcg/ml) was attained at 3.5 hours after administration of CTX and gradually declined thereafter. This amniotic fluid concentration was sufficiently higher than reported MIC90 of CTX against E. coli strains. CTX was used in the treatment of 6 pregnant patients with acute pyelonephritis and 2 with puerperal infections. The bacteriological and clinical responses were both 100%. Since passage of CX into the amniotic fluid is favorable, CTX can be expected to be effective for the prophylaxis of intrauterine amniotic infection associated with early rupture of the membrane. CTX was used in the treatment of a neonate with purulent meningitis. The clinical response was effective. CTX did not cause any noteworthy adverse reactions or laboratory data abnormalities in our patients or neonates.