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Infectious Diseases in Obstetrics and Gynecology
Volume 12 (2004), Issue 2, Pages 57-61
Transplacental Passage of Vancomycin in the ex vivo Human Perfusion Model
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas, Dallas, TX, USA
2UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas 75390-9032, TX, USA
Received 2 October 2003; Accepted 16 January 2004
Copyright © 2004 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives: To determine maternal–fetal transplacental passage of vancomycin in the ex vivo human placental perfusion model.
Methods: Six term placentas were collected immediately after delivery and perfused with physiologic medium using the single cotyledon perfusion system. Vancomycin was added to the maternal medium and perfused through the maternal circulation of the cotyledon. Over a 1-h period in an open system, samples of the perfusate were collected at defined intervals from the fetal venous catheter and from the maternal effluence to assess vancomycin transfer. Thereafter, the system was closed for 1–5 h to establish accumulation. Transport fraction and clearance indexes were calculated by perfusing antipyrine (positive control). Vancomycin was estimated by high pressure liquid chromatography and antipyrine concentration was determined by liquid scintillation.
Results: Mean vancomycin maternal peak and trough concentrations ranged from 30.0 to 51.5 µg/ml and 7.7 to 16.4 µg/ml, respectively. Clearance indexes were minimal with a mean peak range of 0.000–0.080 and a mean trough range of 0.00–0.17. For each placenta, transport fraction for antipyrine was > 1.85 with a single pass of > 40%. No accumulation of vancomycin was noted when the system was closed for 1–5 h. The mean peak clearance index was zero after perfusing the placenta for up to 5 h with 35.8 µg/ml of vancomycin.
Conclusion: Transplacental passage of vancomycin was minimal in the ex vivo human placental perfusion model, with no detectable accumulation.