Antibiotics in pregnancy

Several times per week I am approached by a patient regarding which antibiotics are
safe for her to use in pregnancy.

1. Antibiotics in Pregnancy V Sachar MD
Introduction
Several times per week I am approached by a patient regarding which antibiotics are
safe for her to use in pregnancy. Usually this question comes from their dentist who
wants to perform a dental procedure, and wants to use an antibiotic for prophylaxis.
The concern is that some antibiotics are known teratogens. Teratogens cause
malformations in the developing embryo or fetus. Teratogens can be antibiotics,
viruses, and other substances. Examples of known teratogens include: ACE
inhibitors,radiation, cytomegalovirus, rubella virus, alcohol, cocaine, lead etc.
Most of the information regarding safety of antibiotics in pregnancy are obtained
from women who took the drug "by accident" or when they didn't know they were
pregnant, and then they were followed to see the outcome of the baby. These are
called retrospective studies. Because of safety concerns about risks to the

2. developing baby, pregnant women are
excluded from most drug studies. The FDA
has assigned a letter category to all drugs
that is used to rate a drug's safety in
pregnancy. It is generally accepted that
Category A, and B drugs are safe in
pregnancy.



An excellent resource from the FDA is here: (http://www.fda.gov/ForConsumers/
ByAudience/ForWomen/ucm118567.htm). Known drugs that are teratogens are
given a Category X.
Frequently encountered infections in pregnancy include, urinary tract infections,
pyelonephritits (kidney infection), bladder infection, pneumonia, cold, bronchitis,
sinusitis, among others. A few of the commonly used antibiotics include Amoxicillin,
Ampicillin, Clindamycin,
Erythromycin, Penicillin, Keflex,
Augmentin. These are category B.
In May 2011, the American College of
Obstetricians and Gynecologists
issued a monograph stating that most
antibiotics are safe during pregnancy

3. (http://www.acog.org/About%20ACOG/News%20Room/News%20Releases/2011/Most
%20Antibiotics%20Are%20Safe%20During%20Pregnancy.aspx).
There are many conditions that require that a pregnancy category C drug be taken.
This includes anti-seizure medications, and some mood stabilizer medications
among other. If you are prescribed ANY antibiotics you should have a discussion
with your practitioner to assess the benefit vs risk of taking these medications during
pregnancy.
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