High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels.

Abstract:

OBJECTIVE:To compare umbilical cord and maternal serum peak gentamicin concentration, gentamicin elimination, and clinical outcomes between women who received once-daily compared with standard, thrice-daily dosing for clinical chorioamnionitis. METHODS:We randomly assigned 38 laboring women, at least 34 weeks gestation, with clinical chorioamnionitis, into 1 of 2 gentamicin dosing groups: 5.1 mg/kg every 24 hours (once-daily; n = 18), or 120 mg followed by 80 mg every 8 hours (standard; n = 20). We measured maternal serum peak and delivery gentamicin concentrations and cord serum levels at delivery. Polynomial curve fitting was used to summarize gentamicin elimination. We also compared maternal and neonatal outcomes. RESULTS:Demographic characteristics of the 2 groups were similar. Median maternal peak gentamicin levels were higher with once-daily (18.2 microg/mL) compared with standard dosing (7.1 microg/mL) (P < .001). Maternal serum levels decreased below 2 microg/mL by 10 hours in the once-daily group and by 5 hours in the standard dosing group. Extrapolated peak cord serum levels were 6.9 microg/mL in the once-daily and 2.9 microg/mL in the standard dosing arm. Cord levels decreased below 2 microg/mL by 10 hours in the once-daily and by 5 hours in the standard dosing group. We found no differences in maternal or neonatal outcomes. CONCLUSION:Peak maternal serum gentamicin levels ranged from 13 to 25 microg/mL after a dose of 5.1 mg/kg. Single-dose gentamicin resulted in fetal serum peak levels that were closer to optimal neonatal values. Gentamicin clearance in the term fetus was similar to published values for the newborn infant. No adverse effects of high-dose therapy were noted.

journal_name

Obstet Gynecol

authors

Locksmith GJ,Chin A,Vu T,Shattuck KE,Hankins GD

doi

10.1097/01.AOG.0000151106.87930.1a

subject

Has Abstract

pub_date

2005-03-01 00:00:00

pages

473-9

issue

3

eissn

0029-7844

issn

1873-233X

pii

105/3/473

journal_volume

105

pub_type

临床试验,杂志文章,随机对照试验
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  • Vaginal evisceration.

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    doi:

    authors: Friedel W,Kaiser IH

    更新日期:1975-03-01 00:00:00

  • Thrombosis in a pregnant hemophilia A carrier after intrapartum recombinant factor VIII.

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    journal_title:Obstetrics and gynecology

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    authors: Russell Z,Riconda D,Pollack L,O'Leary TD,Carlan SJ

    更新日期:2005-04-01 00:00:00

  • Control of intractable atonic postpartum hemorrhage by 15-methyl prostaglandin F2 alpha.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Toppozada M,El-Bossaty M,El-Rahman HA,El-Din AH

    更新日期:1981-09-01 00:00:00

  • ACOG Committee Opinion #295: pain relief during labor.

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    pub_type: 指南,杂志文章,实务指引

    doi:

    authors:

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  • Poor perinatal outcome associated with retained cerclage in patients with premature rupture of membranes.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Ludmir J,Bader T,Chen L,Lindenbaum C,Wong G

    更新日期:1994-11-01 00:00:00

  • Cervical intraepithelial neoplasia III: long-term outcome after cold-knife conization with clear margins.

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    pub_type: 杂志文章

    doi:10.1016/s0029-7844(00)01174-1

    authors: Reich O,Pickel H,Lahousen M,Tamussino K,Winter R

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  • Intrapartum fetal cardiac arrhythmias.

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    doi:

    authors: Young BK,Katz M,Klein SA

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  • Factors predisposing to and outcome of gestational diabetes.

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    doi:

    authors: Maresh M,Beard RW,Bray CS,Elkeles RS,Wadsworth J

    更新日期:1989-09-01 00:00:00

  • Changes in thyroid function tests during danazol therapy.

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  • A trial of prophylactic cefamandole in extended gynecologic surgery.

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    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Creasman WT,Hill GB,Weed JC Jr,Gall SA

    更新日期:1982-03-01 00:00:00

  • Serotonin receptor 1A C(-1019)G polymorphism associated with premenstrual dysphoric disorder.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000284448.73490.ac

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    authors: Momplaisir F,Finley E,Wolf S,Aaron E,Inoyo I,Bennett D,Seyedroudbari S,Groves A

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    journal_title:Obstetrics and gynecology

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    doi:

    authors: Copper RL,Goldenberg RL,Cliver SP,DuBard MB,Hoffman HJ,Davis RO

    更新日期:1993-02-01 00:00:00

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/AOG.0b013e31829d888e

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    更新日期:2013-09-01 00:00:00

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    journal_title:Obstetrics and gynecology

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  • Chlorhexidine-alcohol compared with povidone-iodine for surgical-site antisepsis in cesarean deliveries.

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    journal_title:Obstetrics and gynecology

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  • Group A streptococcal puerperal sepsis preceded by positive surveillance cultures.

    abstract:BACKGROUND:Screening of pregnant women for vaginal and rectal carriage of group B streptococci may also identify group A streptococcal carriers. The clinical significance of prenatal group A streptococcal carriage is unknown. CASES:Two women developed group A streptococcal puerperal sepsis after delivery at one hospit...

    journal_title:Obstetrics and gynecology

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    doi:

    authors: Iversen T,Abeler V,Aalders J

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  • Placental insufficiency is characterized by platelet activation in the fetus.

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    pub_type: 杂志文章

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    authors: Trudinger B,Song JZ,Wu ZH,Wang J

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  • Cyclic changes of peritoneal fluid parameters in normal and infertile patients.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Syrop CH,Halme J

    更新日期:1987-03-01 00:00:00

  • Two-year outcome of infants weighing 600 grams or less at birth and born 1994 through 1998.

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    pub_type: 杂志文章

    doi:10.1016/s0029-7844(02)02451-1

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    更新日期:2003-01-01 00:00:00

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)00482-1

    authors: Strigini FA,De Luca G,Lencioni G,Scida P,Giusti G,Genazzani AR

    更新日期:1997-12-01 00:00:00

  • Steroid hormone contraception and bone mineral density: a cross-sectional study in an international population. The WHO Study of Hormonal Contraception and Bone Health.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/s0029-7844(00)00782-1

    authors: Petitti DB,Piaggio G,Mehta S,Cravioto MC,Meirik O

    更新日期:2000-05-01 00:00:00

  • Recurrent obstetric management mistakes identified by simulation.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000265208.16659.c9

    authors: Maslovitz S,Barkai G,Lessing JB,Ziv A,Many A

    更新日期:2007-06-01 00:00:00

  • Abortion training in Canadian obstetrics and gynecology residency programs.

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    pub_type: 杂志文章

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    更新日期:2006-08-01 00:00:00

  • Cordocentesis for the diagnosis and treatment of human fetal parvovirus infection.

    abstract::Human parvovirus B-19 infection was diagnosed by DNA hybridization in blood obtained by cordocentesis from two hydropic fetuses at 22 and 26 weeks' gestation; B-19-specific immunoglobulin M (IgM) in fetal blood was negative in both cases. Hematologic studies demonstrated severe anemia, which was treated by intravascul...

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    doi:

    authors: Peters MT,Nicolaides KH

    更新日期:1990-03-01 00:00:00

  • Practice Bulletin No. 159 Summary: Management of Preterm Labor.

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    doi:

    authors: Terada S,Suzuki N,Uchide K,Ueno H,Akasofu K

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