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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    pub_type: 杂志文章

    doi:

    authors: Seifer DB,Gutmann JN,Grant WD,Kamps CA,DeCherney AH

    更新日期:1993-03-01 00:00:00

  • Diagnosis and management of epithelial ovarian cancer.

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    doi:10.1097/01.AOG.0000220516.34053.48

    authors: Bhoola S,Hoskins WJ

    更新日期:2006-06-01 00:00:00

  • Pregnancy intention and its relationship to birth and maternal outcomes.

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    更新日期:2007-03-01 00:00:00

  • Maternal-fetal surgery: where are we and how did we get here?

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    pub_type: 杂志文章,评审

    doi:10.1097/AOG.0b013e318197c28f

    authors: Chescheir NC

    更新日期:2009-03-01 00:00:00

  • Serum C-reactive protein and Chlamydia trachomatis antibodies in preterm delivery.

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    pub_type: 杂志文章

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    更新日期:2005-07-01 00:00:00

  • Carbon dioxide laser vaporization of diaphragmatic metastases for cytoreduction of ovarian epithelial cancer.

    abstract::Three patients with International Federation of Gynecology and Obstetrics state IIIC ovarian adenocarcinoma underwent CO2 laser vaporization of large-volume (5-6 cm) and miliary right hemidiaphragmatic metastases at the conclusion of standard debulking surgery to effect optimal cytoreduction. Destruction of diaphragma...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Patsner B

    更新日期:1990-10-01 00:00:00

  • Letter: Case of the "missing strings".

    abstract::A method of removing an IUD whose strings may be lost is discussed. Having identified the intrauterine location of the IUD by touch with probe, a second Lippes loop was placed and the long strings not trimmed at all. When the patient returned later the most recently placed loop was removed and the strings of the fir...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Evans GT

    更新日期:1974-07-01 00:00:00

  • Fetal acidemia associated with regional anesthesia for elective cesarean delivery.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/01.AOG.0000215000.65665.dd

    authors: Goldenberg RL,McClure EM,Saleem S,Rouse D,Vermund S

    更新日期:2006-05-01 00:00:00

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Bennett B,Duff P

    更新日期:1991-12-01 00:00:00

  • Endodermal sinus tumor arising in the endometrium.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Pileri S,Martinelli G,Serra L,Bazzocchi F

    更新日期:1980-09-01 00:00:00

  • The effect of postural changes on plasma renin activity during normal and pathologic pregnancies.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Brandes JM,Abramovici H,Katz M,Diengott D,Spindel A,Kahana L

    更新日期:1978-11-01 00:00:00

  • What Is New in Maternal Heart Disease?: Best Articles From the Past Year.

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    pub_type: 杂志文章

    doi:

    authors: Warda AH,Deter RL,Rossavik IK,Carpenter RJ,Hadlock FP

    更新日期:1985-07-01 00:00:00

  • Ondansetron compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial.

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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.0000000000000242

    authors: Abas MN,Tan PC,Azmi N,Omar SZ

    更新日期:2014-06-01 00:00:00

  • The development of fetal heart rate patterns during normal pregnancy.

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    doi:10.1097/00006250-199011000-00017

    authors: Pillai M,James D

    更新日期:1990-11-01 00:00:00

  • Combination of pessary and periurethral collagen injections for nonsurgical treatment of uterovaginal prolapse and genuine stress urinary incontinence.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

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    更新日期:1997-10-01 00:00:00

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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: Lund B,Williamson P

    更新日期:1990-10-01 00:00:00

  • Functional ovarian cysts in relation to the use of monophasic and triphasic oral contraceptives.

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    doi:

    authors: Holt VL,Daling JR,McKnight B,Moore D,Stergachis A,Weiss NS

    更新日期:1992-04-01 00:00:00

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    pub_type: 杂志文章

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    更新日期:1999-03-01 00:00:00

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    pub_type: 临床试验,杂志文章

    doi:

    authors: Haberman S,Friedman Z

    更新日期:1998-08-01 00:00:00

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

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  • Birth Behind Bars: The Need for Labor Support in the Incarcerated Population.

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    doi:

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    doi:

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