Pharmacokinetics and Target Attainment of Antimicrobial Drugs Throughout Pregnancy. Part II: Cephalosporins

Resumen del estudio

RESULTS: Of 219 articles identified, 44 met the inclusion criteria, covering 14 out of 35 cephalosporins. During second (T2) and third (T3) trimesters of pregnancy, Vd (9.2-18.4%) and CL (30.8-100%) were higher compared with nonpregnant, first trimester, or postpartum women. Consequently, reduced target attainment was reported in T2 and T3 pregnant women. Evidence-based dosing regimens were proposed for pregnant women receiving cefazolin, cefuroxime, cefoxitin, ceftazidime, cephradine, cefatrizine, and ceftizoxime. CONCLUSIONS: During pregnancy, an increase in Vd and CL was observed, indicating a potential need for higher or additional dosages, or shorter dosing intervals to achieve target attainment. However, evidence-based dosing adjustments were identified for only seven cephalosporins. These findings highlight significant gaps in knowledge and underscore the need for further research to characterize PK profiles and establish dosing recommendations for the remaining cephalosporins in pregnant women. © 2026. The Author(s). DOI: 10.1007/s40262-026-01696-4 PMCID: PMC13624020