Antibiotics and Pregnancy:
Antimicrobial drugs (antibiotics) are frequently administered to pregnant women due to common occurrence of bacterial infections during the prenatal period. The use of antibiotics during pregnancy raises great concern about possibility of adverse effects that these drugs may have on the foetus, though details related to the effects of many of these drugs remains poorly understood. If an antibiotic must be prescribed, it is important to be aware of the effects such drugs can have on pregnancies, in order to prescribe the most suitable treatment with the least risk to the pregnancy.
Because of ethical problems involved in conducting antibiotics studies in pregnant patients, recommendations for antibiotics uses are heavily influenced by animals studies and medical experiences. Criteria for appropriate use of these agents have been reviewed, and a classification has been established by the food and drug administration.
Antibiotics classified according to FDA pregnancy categories.
Category description
Example
a. No human fetal risk on basis of controlled human studies
b. No evidence of human fetal riskl possible evidence of animal fetal toxicity
Bata lactams and betalactam inhibitors, cephalosparins, monobactams, enthromycin, monobactams, enythromycine, azithromycine, nalidixic acid metranidazole, sulfenamides, amplotericin B.
c. Human fetal risk unknown or definitive evidence of animal fetal toxicity
Carbapenems, gentamicin, elrinthromycin, vomvomycin, fluoroquinolones, trimethoprim
d. human fetal risk noted; potential benefits justify the use when safer alternative available
Aminogcosides tetracyclines, streptomycin sulphate
x. Human fetal risk outweighs benefits contra indicated for use in pregnancy.
The penicillin’s including those in combination with beta lantamas inhibitors (cleulanic acid, sulbactam sodium, tazobactam sodium), the cephalosporinsa, and aztreonam, as well as erythromycin base, azithromycin (zithromax), and clindamycin, have been designated as category B (no evidence of human fetal risk). The fluoroguniolones, tetracyclines and aminoglycosides should not be given be pregnant patents unless there are no safe and effective alternative drugs to manage their infections.
Sulfonamides should not be prescribed to women in late pregnancy because of the potential for displacement of bilinibin from its binding sites and the possibility for the development of hyperbilinbinemi and kernicterus.
Metronidazole (flagyl, protestat) is classified as a category B ding, although there is some concern about its potential tetratogenicity, and there remains the sentiment that this medication should not be prescribed to patients in the first trimester. It has been recommended that trimethoprim be avoided in pregnant patients. There is no evidence that this compound is harmful, but another folate antagonist, methotrxae (folex, rhenumatrex dose pack), is tetratogenic.
Administration of some antibiotics such as amoxicillin (Amoxil, wymox) and doxycycline (Doryx, vibramycine, vibra-tabs), has been associated with further of oral contraceptive. It remains unresolved, however whether these antibiotic actually contribute to the failure.
Antimicrobial drugs (antibiotics) are frequently administered to pregnant women due to common occurrence of bacterial infections during the prenatal period. The use of antibiotics during pregnancy raises great concern about possibility of adverse effects that these drugs may have on the foetus, though details related to the effects of many of these drugs remains poorly understood. If an antibiotic must be prescribed, it is important to be aware of the effects such drugs can have on pregnancies, in order to prescribe the most suitable treatment with the least risk to the pregnancy.
Because of ethical problems involved in conducting antibiotics studies in pregnant patients, recommendations for antibiotics uses are heavily influenced by animals studies and medical experiences. Criteria for appropriate use of these agents have been reviewed, and a classification has been established by the food and drug administration.
Antibiotics classified according to FDA pregnancy categories.
Category description
Example
a. No human fetal risk on basis of controlled human studies
b. No evidence of human fetal riskl possible evidence of animal fetal toxicity
Bata lactams and betalactam inhibitors, cephalosparins, monobactams, enthromycin, monobactams, enythromycine, azithromycine, nalidixic acid metranidazole, sulfenamides, amplotericin B.
c. Human fetal risk unknown or definitive evidence of animal fetal toxicity
Carbapenems, gentamicin, elrinthromycin, vomvomycin, fluoroquinolones, trimethoprim
d. human fetal risk noted; potential benefits justify the use when safer alternative available
Aminogcosides tetracyclines, streptomycin sulphate
x. Human fetal risk outweighs benefits contra indicated for use in pregnancy.
The penicillin’s including those in combination with beta lantamas inhibitors (cleulanic acid, sulbactam sodium, tazobactam sodium), the cephalosporinsa, and aztreonam, as well as erythromycin base, azithromycin (zithromax), and clindamycin, have been designated as category B (no evidence of human fetal risk). The fluoroguniolones, tetracyclines and aminoglycosides should not be given be pregnant patents unless there are no safe and effective alternative drugs to manage their infections.
Sulfonamides should not be prescribed to women in late pregnancy because of the potential for displacement of bilinibin from its binding sites and the possibility for the development of hyperbilinbinemi and kernicterus.
Metronidazole (flagyl, protestat) is classified as a category B ding, although there is some concern about its potential tetratogenicity, and there remains the sentiment that this medication should not be prescribed to patients in the first trimester. It has been recommended that trimethoprim be avoided in pregnant patients. There is no evidence that this compound is harmful, but another folate antagonist, methotrxae (folex, rhenumatrex dose pack), is tetratogenic.
Administration of some antibiotics such as amoxicillin (Amoxil, wymox) and doxycycline (Doryx, vibramycine, vibra-tabs), has been associated with further of oral contraceptive. It remains unresolved, however whether these antibiotic actually contribute to the failure.