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Review Articles
NUMBER 3-4 YEAR 2011
Infections, Antibiotics and Pregnancy
1 Department of Pharmacology,
2 Department of Neonatology,
3 Department of Public Health, Victor Babes University of Medicine and Pharmacy Timisoara

Correspondence to:
Simona Sipos, Department of Pharmacology, Victor Babes University of Medicine and Pharmacy,
2A E. Murgu Sq., 300041 Timisoara,
Tel. +40256204476.
Email: simosipos@yahoo.com
REZUMAT
Femeile gravide prezinta deseori in timpul sarcinii infectii urinare, boli cu transmitere sexuala sau pot fi purtatoare de streptococ beta-hemolitic, motive pentru care este necesara instituirea tratamentului cu antibiotice. De asemenea, se aplica o terapie standard cu antibiotice femeilor cu nasteri premature si ruptura prematura a membranelor inainte de travaliu (RPM). Antibioticele pentru RPM reduc complicatiile datorate nasterii premature si infectiilor postnatale. Modificarile fiziologice survenite in cursul sarcinii determina particularitati farmacocinetice care pot afecta eficienta agentilor antimicrobieni. Un motiv serios de ingrijorare este reprezentat de posibilul risc de producere al efectelor teratogene si toxice pentru fat. În general, femeile gravide sunt excluse din trialurile clinice, iar informatiiile farmacocinetice referitoare la administrarea si dozarea corecta a antimicrobienelor la aceasta populatie sunt insuficiente. Desi majoritatea antimicrobienelor pot traversa bariera hemato-placentara, datele referitoare la potentialele efecte teratogene si toxicitatea fetala si neonatala provocata de aceste medicamente sunt limitate si relativ variabile. Prezentul articol recenzeaza datele disponibile cu relevanta clinica semnificativa referitoare la farmacologia antibioticelor celor mai frecvent utilizate in sarcina, cu preponderenta pe toxicitatea fetala.

ABSTRACT
Pregnant women often present in the evolution of pregnancy urinary tract infections, sexually transmitted infections and group beta streptococcus carriage requiring treatment with antibiotics. Also, it is standard practice to give antibiotics to women with pre-term, prelabor rupture of membranes (PROM). Antibiotics for PROM reduce complications due to pre-term delivery and post-natal infection. The physiologic changes that occur during pregnancy result in pharmacokinetic changes that can alter the effectiveness of antimicrobial agents. The possible risk of teratogenic and toxic effects of antibiotics on the fetus is an additional cause of concern. In general, pregnant women are excluded from clinical trials and there is little pharmacokinetic information on the use and proper dosing of antimicrobials in this population. Although most antimicrobials can cross the placental blood barrier, data on the potential teratogenic effects, fetal and neonatal toxicity caused by these drugs are also limited and off varying reliability. This article reviews the available evidence with the greatest clinical relevance regarding the pharmacology of different antibiotic agents in pregnancy, with particular focus on data related to fetal toxicity.


"Victor Babes" Publishing House "Victor Babes" University of Medicine and Pharmacy Romanian Academy of Medical Sciences National Council of Scientific Research in Higher Education (B+) Index Copernicus
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