[Drugs for respiratory tropism and pregnancy]

The pharmokinetics of drugs used to treat lung disease in pregnant women undergo changes due to the physiological variations induced by pregnancy. Dosage must therefore be adapted; increased doses are often required for the treatment of severe lung infections. Most drugs used for lung disease have a teratogenic potential and thus carry a risk for the fetus. Drugs used for asthma usually present little risk for the fetus. Administration by inhalation is particularly well adapted as it limits systemic diffusion. Excessively high doses can however lead to neonatal toxicity. Penicillins, cephalosporins and erythromycin have been shown to be well tolerated and are the choice antibiotics. Aminoglycosides require careful monitoring due to the risk of renal and auditory toxicity. Fluoroquinolones, sulfamides and tetracyclines should be avoided. Available data on recent compounds such as the new macrolides (azithromycin, clarithromycin) are too limited for recommending their use during pregnancy. In case of resistant tuberculosis, it is sometimes necessary to prescribe a second choice anti-tuberculosis drug with known or suspected fetal toxicity.