Premium
Amoxicillin Pharmacokinetics in Pregnant Women: Modeling and Simulations of Dosage Strategies
Author(s) -
Andrew M A,
Easterling T R,
Carr D B,
Shen D,
Buchanan M L,
Rutherford T,
Bennett R,
Vicini P,
Hebert M F
Publication year - 2007
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/sj.clpt.6100126
Subject(s) - amoxicillin , pharmacokinetics , medicine , pregnancy , gestation , antibiotics , reabsorption , pharmacology , obstetrics , chemistry , kidney , biology , biochemistry , genetics
Amoxicillin is recommended for anthrax prevention in pregnancy. The objective of this study was to evaluate the pharmacokinetics of amoxicillin during pregnancy and postpartum (PP). Sixteen women received amoxicillin during gestation (18–22 weeks (T2) and 30–34 weeks (T3)) as well as 3 months postpartum (PP) to evaluate single‐dose pharmacokinetics. Amoxicillin compartmental pharmacokinetic parameters were used to simulate amoxicillin concentration–time profiles following different dosage strategies. Amoxicillin CL renal (T2: 24.8±6.7 l/h, P <0.001; T3: 24.0±3.9 l/h, P <0.001; and PP: 15.3±2.6 l/h) and renal CL secretion (T2: 280±105 ml/min, P <0.002; T3: 259±54 ml/min, P <0.001; and PP: 167±47 ml/min) were higher during pregnancy than postpartum. Simulations suggest that amoxicillin concentrations adequate to prevent anthrax may be difficult to achieve during pregnancy and postpartum. Increases in amoxicillin CL renal and renal CL secretion reflect increases in filtration and secretory transport or diminished reabsorption in the kidneys. Amoxicillin may not be an appropriate antibiotic for post‐anthrax exposure prophylaxis. Clinical Pharmacology & Therapeutics (2007) 81 , 547–556. doi: 10.1038/sj.clpt.6100126 ; published online 28 February 2007.