The role of various transporters in the placental uptake of ofloxacin in an in vitro model of human villous trophoblasts.

Introduction: Six years after the US Food and Drug Administration approval of the broad-spectrum antibiotic ofloxacin (OFLX), the chiral switching of this racemic mixture resulted in a drug composed of the L-optical isomer levofloxacin (LVFX). Since both fluoroquinolones (FQs) were introduced to the pharmaceutical market, they have been widely prescribed by physicians, with careful administration during pregnancy and breastfeeding. Therefore, the role of the influx and efflux placental transporters in the concentrations of these drugs that permeate through human placental barrier model was investigated in this study.

Spinal versus general anesthesia in cesarean sections: the effects on postoperative pain perception.

Objective: To compare postoperative pain perception and analgesia requirements in patients undergoing cesarean section (CS) using general versus spinal anesthesia.

Study Design: A prospective, observational study of patients undergoing elective CS during 2009 under either general or spinal anesthesia. Postoperative pain intensity and analgesia requirements were evaluated for up to 48 h after surgery.

A randomized, double-blind, placebo-controlled trial of selective digestive decontamination using oral gentamicin and oral polymyxin E for eradication of carbapenem-resistant Klebsiella pneumoniae carriage.

Objective: To assess the effectiveness of selective digestive decontamination (SDD) for eradicating carbapenem-resistant Klebsiella pneumoniae (CRKP) oropharyngeal and gastrointestinal carriage.

Design: A randomized, double-blind, placebo-controlled trial with 7 weeks of follow-up per patient.

Setting: A 1,000-bed tertiary-care university hospital.

[Joint cartilage lesions caused by quinolones in young animals--can we generalize to children?].

A number of new generation fluoroquinolone antibiotics are currently available for use in hospital and community-based settings. This antibiotic class possesses a broad anti-bacterial spectrum of activity, can be administered orally as well as intravenously, and is, generally, well-tolerated, causing few adverse drug reactions. Lesions in articular cartilage were observed in animal studies conducted in young animals, mostly Beagle dogs and rats.

Preoperative analgesia with local lidocaine infiltration for post cesarean delivery pain management.

Objective: To evaluate the impact of local lidocaine incision-site injection in patients undergoing cesarean deliveries (CD), on post operative pain and analgesic requirements.

Study Design: In this prospective, double-blinded, placebo-controlled study, patients undergoing elective CD were randomly assigned to receive 1% lidocaine solution or placebo to the incision site, prior to the performance of a Pfannenstiel incision. Pain intensity was evaluated for up to 48 hours after surgery and analgesic requirements of the patients were recorded.

Nitrofurantoin transport by placental choriocarcinoma JAr cells: involvement of BCRP, OATP2B1 and other MDR transporters.

Objective: To determine the role of BCRP in nitrofurantoin (NF) transport in JAr cells and the possible contribution of OATP2B1, P-gp and MRPs to this transport.

Methods: Cells were incubated with various BCRP, P-gp, MRPs, organic anion transporting polypeptide (OAT) and OATP2B1 inhibitors for 15 min, followed by incubation for 30 min with NF, with or without the inhibitors mentioned earlier. NF cytotoxicity was examined using neutral red (NR) assay.

Carrier-mediated uptake of Levofloxacin by BeWo cells, a human trophoblast cell line.

Objective: Placental transfer of Levofloxacin (LF), a broad spectrum fluoroquinolone antibiotic, and its inhibition was investigated in BeWo cells, a human trophoblast cell line.

Methods: The experiments of LF uptake by BeWo cells were performed after preincubation and in the presence of the P-glycoprotein inhibitors (Cyclosporin A, Verapamil and Quercetin), the organic anion/cation transporter inhibitor (Cimetidine) and the MCT substrates (lactic acid and salicylic acid).

Results: P-glycoprotein inhibitors increased the uptake of LF by BeWo cells.

Transfer of ciprofloxacin, ofloxacin and levofloxacin across the perfused human placenta in vitro.

Objective: To investigate the transfer of therapeutically important fluoroquinolones: ciprofloxacin, ofloxacin and levofloxacin, through the isolated perfused human placenta, from the maternal to the fetal compartment.

Study Design: Isolated placental cotyledons from normal human term placentae were dually perfused with M199 medium enriched with 3g/l bovine serum albumin and 1g/l glucose. Perfusion rates were 12 and 6 ml/min in the maternal and fetal circulation, respectively.

Transfer of insulin lispro across the human placenta.

Our in vitro perfusion study confirms the result of the Boskovic et al., that insulin lispo is not crossing the human placental membranes at low concentrations. In our study maternal steady state concentration reached 48 +/- microU in the maternal artery and 28 +/- 1 microU in the maternal vein, while in the fetal site insulin lispo was not detected.