Transplacental transfer of vancomycin and telavancin.

Abstract

We sought to determine the bidirectional transfer and distribution of vancomycin and telavancin across the dually perfused term human placental lobule. The technique of dually perfused placental lobule was used in its recirculating mode to determine the maternal to fetal (M→F) (n = 20) and fetal to maternal (n = 18) transfer of each antibiotic, which were coperfused with their radioactive isotopes. The concentrations of drugs were determined by liquid scintillation spectrometry. In the M→F direction, the transfer of vancomycin (9.6 ± 4%) and telavancin (6.5 ± 2%) were low; however, telavancin retention by the perfused lobule was greater than that of vancomycin (P < .01). The normalized transplacental transfer of telavancin across the placental lobule in the fetal to maternal direction was higher than in the M→F direction (P < .01), suggesting the involvement of placental efflux transporters. The ex vivo perfusion experiments revealed low transfer of vancomycin and telavancin to the fetal circuit.