Vancomycin Pharmacokinetics in a Pregnancy Rat Model

Sean N. Avedissian, Gwendolyn M. Pais, Michelle Pham, Jiajun Liu, Jack Chang, Khrystyna Hlukhenka, Walter Prozialeck, Brooke Griffin, Anil Gulati, Medha D. Joshi, Ying Mu, Marc H. Scheetz

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Vancomycin usage is often unavoidable in pregnant patients; however, literature suggests vancomycin can cross the placental barrier and reach the fetus. Understanding the mass transit of vancomycin to the fetus is important in pregnancy. We aimed to (i) identify a relevant population pharmacokinetic (PK) model for vancomycin in pregnancy and (ii) estimate PK parameters and describe the mass transit of vancomycin from mother to pup kidneys. Pregnant Sprague-Dawley rats (i.e., trimester 1 and trimester 3) received 250 mg/kg vancomycin once daily for three days through intravenous injection via an internal jugular vein catheter. Vancomycin concentrations in maternal plasma and pup kidneys were quantified via liquid chromatography- tandem mass spectrometry (LC-MS/MS). Multiple compartment models were fitted and assessed using a nonparametric approach with Pmetrics. A total of 10 vancomycin- treated rats and 48 pups contributed PK data. A 3-compartment model adjusted for trimester fit the data well (maternal plasma Bayesian, observed versus predicted R2 = 0.978; pup kidney Bayesian, observed versus predicted R2 = 0.999). The mean rate constant for vancomycin mass transit to the pup kidney was 0.72 h21 for trimester 1 dams and 0.75 h21 for trimester 3 dams. Median vancomycin concentrations in pup kidneys from trimester 3 were significantly higher than those in trimester 1 (8.62 versus 0.36 mg/mL, P < 0.001). Vancomycin transited to the fetus from the mother and was; kidney accumulation differed by trimester. This model may be useful for a translational understanding of vancomycin distribution in pregnancy to ensure efficacious and safe doses to both mother and fetus.

Original languageEnglish (US)
JournalAntimicrobial Agents and Chemotherapy
Volume66
Issue number5
DOIs
StatePublished - May 2022

Keywords

  • pharmacokinetics
  • pregnancy
  • vancomycin

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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