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[Studies on imipenem/cilastatin sodium in the perinatal period]
1Department of Obstetrics and Gynecology, School of Medicine, Showa University.
Insights
Imipenem/cilastatin sodium (IPM/CS) demonstrates potent bactericidal effects against perinatal pathogens in amniotic fluid. This antibiotic effectively penetrates the placenta, proving safe and beneficial for treating perinatal infections.
Area of Science:
- Perinatal pharmacology
- Infectious disease
- Antimicrobial research
Background:
- Perinatal infections pose significant risks to mothers and newborns.
- Effective and safe antimicrobial agents are crucial for managing these infections.
- Imipenem/cilastatin sodium (IPM/CS) is a broad-spectrum antibiotic with potential utility in the perinatal period.
Purpose of the Study:
- To evaluate the pharmacokinetic, bacteriological, and clinical efficacy of imipenem/cilastatin sodium (IPM/CS) during the perinatal period.
- To assess the drug's effects on bacterial growth and its penetration across the placenta.
- To determine the safety and effectiveness of IPM/CS in treating perinatal infections.
Main Methods:
- Bacteriological studies determined the effects of IPM on Staphylococcus aureus and Escherichia coli growth curves in amniotic fluid.
- Pharmacokinetic analysis measured IPM and CS levels in maternal plasma, umbilical cord plasma, and amniotic fluid after intravenous administration.
- Clinical assessments evaluated the efficacy and safety of IPM/CS in pregnant women and their neonates.
Main Results:
- IPM exhibited enhanced bactericidal effects in amniotic fluid, particularly against resistant bacterial strains.
- IPM and CS were rapidly absorbed and distributed, with favorable placental penetration to the fetus.
- Achieved drug concentrations in umbilical cord plasma and amniotic fluid exceeded minimum inhibitory concentrations (MICs) for key pathogens.
- Clinical use demonstrated IPM/CS to be effective in treating perinatal infections with no observed side effects.
Conclusions:
- IPM/CS is pharmacokinetically suitable for use in the perinatal period.
- The antibiotic demonstrates significant bactericidal activity against relevant perinatal pathogens.
- IPM/CS is a safe and effective option for the prophylaxis and treatment of perinatal infections.
Abstract:
Pharmacokinetic, bacteriological and clinical studies of imipenem/cilastatin sodium (IPM/CS) were carried out in the perinatal period, and the results obtained are summarized as follows: Effects of IPM on bacterial growth curves of Staphylococcus aureus (sensitive and resistant strains) and Escherichia coli (sensitive strains) in amniotic fluid were determined. The bactericidal effects of IPM increased in amniotic fluid and remarkable increases against resistant strains were demonstrated. IPM and CS were detected promptly after intravenous drip infusion to pregnant women, and reached peak levels shortly after administration in maternal plasma. Placental penetration of IPM and CS to the fetus was favorable. After intravenous drip infusion of 500 mg/500 mg of IPM/CS, drug concentrations in the umbilical cord plasma and the amniotic fluid exceeded MICs against main pathogenic organisms. Clinically, IPM/CS was effective in the treatment of perinatal infections without any side effect. The above results demonstrated that IPM/CS is a clinically useful antibiotic for the prophylaxis and the treatment of perinatal infections.