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Published on: August 2, 2017
Vancomycin Concentrations in Umbilical Cord Blood After Intrapartum Exposure
Sarah A Coggins1, Kelly C Wade, Kevin M Watt
1Division of Neonatology, Clinical Futures, and the Division of Infectious Diseases, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania; and the Division of Clinical Pharmacology, Department of Pediatrics, University of Utah, Salt Lake City, Utah.
Maternal vancomycin dosing for Group B Streptococcus (GBS) prophylaxis effectively transfers to neonates. Most newborns had cord blood vancomycin levels exceeding the GBS minimum inhibitory concentration (MIC) breakpoint, ensuring adequate protection.
Area of Science:
- Pharmacology
- Neonatal Medicine
- Infectious Disease
Background:
- Group B Streptococcus (GBS) prophylaxis during labor is crucial for preventing neonatal infections.
- Limited data exists on fetal-neonatal pharmacokinetics of weight-based vancomycin dosing for GBS prophylaxis.
- Understanding drug transfer is vital for optimizing treatment strategies.
Purpose of the Study:
- To quantify vancomycin concentrations in umbilical cord blood after maternal weight-based intrapartum administration.
- To evaluate cord blood vancomycin levels against the GBS clinical minimum inhibitory concentration (MIC) breakpoint.
Main Methods:
- Analysis of stored umbilical cord blood sera from 26 neonates.
- Measurement of vancomycin levels using established laboratory techniques.
- Comparison of measured levels to the GBS MIC breakpoint of 1 microgram/mL.
Main Results:
- Vancomycin was detected in the umbilical cord blood of all neonates studied.
- A high proportion of neonates (92.3%) had cord blood vancomycin levels above the GBS MIC breakpoint.
- This suggests effective fetal drug exposure and potential protection against GBS.
Conclusions:
- Weight-based maternal intrapartum vancomycin administration achieves therapeutic concentrations in neonates.
- This dosing strategy appears effective in providing fetal-neonatal prophylaxis against GBS.
- Further pharmacokinetic studies may refine optimal dosing regimens.
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