Document Detail


Maternal azithromycin therapy for Ureaplasma intraamniotic infection delays preterm delivery and reduces fetal lung injury in a primate model.
MedLine Citation:
PMID:  23111115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We assessed the efficacy of a maternal multidose azithromycin (AZI) regimen, with and without antiinflammatory agents to delay preterm birth and to mitigate fetal lung injury associated with Ureaplasma parvum intraamniotic infection.
STUDY DESIGN: Long-term catheterized rhesus monkeys (n = 16) received intraamniotic inoculation of U parvum (10(7) colony-forming U/mL, serovar 1). After contraction onset, rhesus monkeys received no treatment (n = 6); AZI (12.5 mg/kg, every 12 h, intravenous for 10 days; n = 5); or AZI plus dexamethasone and indomethacin (n = 5). Outcomes included amniotic fluid proinflammatory mediators, U parvum cultures and polymerase chain reaction, AZI pharmacokinetics, and the extent of fetal lung inflammation.
RESULTS: Maternal AZI therapy eradicated U parvum intraamniotic infection from the amniotic fluid within 4 days. Placenta and fetal tissues were 90% culture negative at delivery. AZI therapy significantly delayed preterm delivery and prevented advanced fetal lung injury, although residual acute chorioamnionitis persisted.
CONCLUSION: Specific maternal antibiotic therapy can eradicate U parvum from the amniotic fluid and key fetal organs, with subsequent prolongation of pregnancy, which provides a therapeutic window of opportunity to effectively reduce the severity of fetal lung injury.
Authors:
Peta L Grigsby; Miles J Novy; Drew W Sadowsky; Terry K Morgan; Mary Long; Ed Acosta; Lynn B Duffy; Ken B Waites
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-23
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  207     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-23     Completed Date:  2013-02-05     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  475.e1-475.e14     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Animals
Anti-Bacterial Agents / administration & dosage*
Anti-Inflammatory Agents / administration & dosage
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
Azithromycin / administration & dosage*
Chorioamnionitis / drug therapy*,  microbiology
Dexamethasone / administration & dosage
Drug Therapy, Combination
Female
Fetal Diseases / prevention & control
Indomethacin / administration & dosage
Lung Injury / prevention & control*
Macaca mulatta
Polymerase Chain Reaction
Pregnancy
Premature Birth / prevention & control*
Treatment Outcome
Ureaplasma / drug effects,  isolation & purification*
Ureaplasma Infections / drug therapy*,  microbiology
Grant Support
ID/Acronym/Agency:
8P51OD011092-53/OD/NIH HHS; HD043488/HD/NICHD NIH HHS; K99 HD055053/HD/NICHD NIH HHS; K99/R00 HD055059/HD/NICHD NIH HHS; K99/R00/HD055053/HD/NICHD NIH HHS; P51 RR000163/RR/NCRR NIH HHS; R00 HD055053/HD/NICHD NIH HHS; R01 A1072577//PHS HHS; R01 AI072577/AI/NIAID NIH HHS; R01 HD006159/HD/NICHD NIH HHS; R01 HD069610/HD/NICHD NIH HHS; R01 HD6159/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Inflammatory Agents; 0/Anti-Inflammatory Agents, Non-Steroidal; 7S5I7G3JQL/Dexamethasone; 83905-01-5/Azithromycin; XXE1CET956/Indomethacin
Comments/Corrections

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