Understanding the Pharmacokinetics of Antibiotics in Pregnancy: Is There a Role for Therapeutic Drug Monitoring? A Narrative Review

• Published in: Therapeutic drug monitoring Vol. 44; no. 1; pp. 50 - 64
• Main Authors: Stojanova, Jana, Arancibia, Marcelo, Ghimire, Samiksha, Sandaradura, Indy
• Format: Journal Article
• Language: English
• Published: United States Therapeutic Drug Monitoring 01-02-2022; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Anti-Bacterial Agents; Antibiotics; Drug Monitoring; Female; Humans; Maternal-Fetal Exchange; Pharmacokinetics; Pregnancy; Prenatal exposure; Therapeutic drug monitoring
• ISSN: 0163-4356; 1536-3694
• DOI: 10.1097/FTD.0000000000000950

Antibiotics are commonly used during pregnancy. However, physiological changes during pregnancy can affect the pharmacokinetics of drugs, including antibiotics, used during this period. Pharmacokinetic evaluations have shed light on how antibiotics are affected during pregnancy and have influenced dosing recommendations in this context.
A narrative review was conducted and included reports providing data reflecting drug distribution and exposure in the context of pregnancy.
Pharmacokinetic parameters of antibiotics in pregnancy and transplacental passage of antibiotics are comprehensively presented.
Knowledge about the impact on pharmacokinetics and fetal exposure is especially helpful for complicated or severe infections, including intra-amniotic infection and sepsis in pregnancy, where both mother and fetus are at risk. Further studies are warranted to consolidate the role of therapeutic drug monitoring in complicated or severe infections in pregnant patients.