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Although antibiotics are commonly prescribed to pregnant women, details relating to the effects of many of these drugs remains poorly understood.
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If an antibiotic must be prescribed, it is important to be aware of the effects such drugs can have on pregnancies, in order to prescribe the most suitable treatment with the least risk to mother and fetus. Ceftriaxone is a third generation cephalosporin, commonly used in general practice for various infections in all age groups, because of its antimicrobial activity against many gram-positive and gram-negative organisms. Pharmacokinetic changes occurring during pregnancy, as well as fetal pharmacokinetics and passage of the drugs to the unborn are correlated with reproductive and developmental pharmacology.
The passage of cephalosporins is different in the three stages of pregnancy. Because of these considerations, our study involved pregnant women of all three trimesters of pregnancy, who received treatment with ceftriaxone. In the third month of pregnancy, the fetal liver is already capable of activating or inactivating chemical substances through oxidation 8.
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It is very important that, in the fetal compartment, the detoxification of drugs and their metabolites takes place at a low level, certainly in the first half of pregnancy. The excretion in the amniotic volume prostate normal cm3 explains the accumulation of biological active substances might take place in the fetal compartment.
Although fetal treatment is still an exception, it is of great interest that in the case of prevention of vertical infections, at the time of functioning circulation and kidney excretion, antibiotics penicillins, cephalosporins concentrate in the fetal compartment 9.
Our prospective and comparative study did not reveal statistical significant differences among study groups Table I. In accordance with other researches we concluded that ceftriaxone is a safe antibiotic Considering all these, some adverse effects during ceftriaxone therapy are important to be revealed.
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In previous studies we revealed the importance of drug-induced lithiasis and the composition of ceftriaxone calculi In the present study we revealed reversible precipitates in the gallbladders of 2 pregnant women who received ceftriaxone in the second trimester and 3 in the third trimester; the duration of therapy was ten days, prostatita și culoarea scaunului reported in the literature Both ceftriaxone exposure cases and their references had only minor malformations in the newborn, revealed within the expected baseline risk for the general population.
The five minor malformations in the ceftriaxone study group were as follows: volume prostate normal cm3 cases of undescended testis, one case of metatarsus adductus, one haemangioma, one minor syndactyly, and one case of left hallux valgus associated with left preauricular trags Figures 3 and 4 : Fig. Left halux valgus in a neonate after maternal second trimester exposure to ceftriaxone The presence of preauricular trags requires an attentive follow-up of the patient for hearing impairment and especially for hidden abnormalities of the urinary tract.
Volume prostate normal cm3 preauricular traggs in a neonate after maternal third trimester exposure to ceftriaxone All three neonates were born at term and weighted over grams. They were icteric, with the liver palpable 3 cm below the right costal un atac de prostatită acută no splenomegaly was associated.
After 3 days the icterus subsided and the blood testes normalized. The reversible cholestatic syndrome in the newborn has been widely discussed in the literature Frequently, a reversible higher level of liver enzymes may prove the previously action of ceftriaxone 16, The presented study has some limitations.
One limitation is the small sample size and the broad confidence limits. The precise mechanisms of ceftriaxone action during pregnancy will be clarified by further studies.
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Biliary pseudolithiasis and newborn cholestasis are possible adverse effects due to extensively drug use. Infections, antibiotics and pregnancy. Timisoara Medical Journal, ; 61 : Pyelonephritis in pregnancy: once-a-day ceftriaxone versus multiple doses opf cefazolin. A randomized, double-blind trial.
Am J Obstet Gynecol ; 1 : First trimester exposure to cefuroxim. Br J Clin Pharmacol ; Drugs during Pregnancy and Lactation. Treatment Options and Risk Assessment. Second Ed. Ravkin AM. Hepatocellular enzyme elevations in a patient receiving ceftriaxone. Am J Health Syst Volume prostate normal cm3 ; Classification of drugs for teratogenic risk: an anachronistic way of counseling: a reply to Merlob and Stahl.
Birth Defects Res A ; Mechanisms regulating toxicant disposition of the embryo during early pregnancy: an interspecies comparison.
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Juchau MR. Bioactivation in chemical teratogenesis. Ann Rev Pharmacol Toxicol ; Knothe GA, Dette A. Antibiotics in pregnancy. Infection ; Biliary sludge and hyperbilirubinemia associated with ceftriaxone in an adult: Case report and review of the literature.
Pharmacotherapy ; 25, Drug-induced calculi.
Identification, structure and composition. Ceftraxone associated gallbladder pseudolithiasis. Acta Pediatr 88, Pharmacokinetics and safety of ceftriaxone in neonate.
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Eur J Pediatr ; Reversible symptomatic biliary obstruction associated with pseudolithiasis. Am J Gastroenterol ; Preterm birth reduction after ceftriaxone treatment during pregnancy. Ceftriaxone induced cholelithiasis in a neonate. A case report.
Ind J Med Sci. Nephrolithiasis associated with ceftriaxone therapz. A prospective study in 51 children. Arch Dis Child ; Examinarea riscului de aparitie a anomaliilor congenitale, nasterilor premature, greutate mica la nastere si afectarea functiei hepatice dupa expunerea in utero la ceftriaxona.