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[Risks of antibacterial agents in pregnancy]
Salvatore Nardiello1, Teresa Pizzella, Rosanna Ariviello
1Dipartimento di Malattie Infettive, Seconda Università degli Studi di Napoli, Italy.
Le Infezioni in Medicina
|April 18, 2003
Summary
Choosing safe antimicrobial drugs during pregnancy is crucial. Penicillins, cephalosporins, and erythromycin are generally safe, while others require careful risk-benefit assessment for mother and fetus.
Area of Science:
- Pharmacology
- Maternal-Fetal Medicine
- Infectious Diseases
Context:
- Antimicrobial drug selection during pregnancy requires careful consideration of risks to both the developing fetus and the mother.
- Extensive clinical data informs the safety profiles of various antibacterial agents in pregnant populations.
Purpose:
- To review the safety of antimicrobial agents used in pregnant women.
- To guide clinicians in selecting appropriate antibacterial therapies during pregnancy.
- To highlight drugs with known risks and those considered safe.
Summary:
- Penicillins, cephalosporins, and erythromycin (excluding estolate) are considered safe for pregnant women and fetuses.
- Nitrofurantoin is acceptable except in late pregnancy; isoniazid and ethambutol are safest for tuberculosis, with maternal isoniazid toxicity noted.
- Agents like aminoglycosides, fluoroquinolones, and vancomycin carry potential risks but may be used if no safer alternatives exist.
- Tetracyclines, cotrimoxazole, chloramphenicol, and clindamycin should be avoided due to significant risks.
- Safety data for newer agents like carbapenems and ketolides is limited.
Impact:
- Provides essential information for optimizing antimicrobial therapy in pregnant patients.
- Aims to reduce adverse fetal and maternal outcomes associated with antibiotic use in pregnancy.
- Emphasizes the need for more research on the safety of various antimicrobials in pregnancy.