In silico QSAR modeling to predict the safe use of antibiotics during pregnancy

The use of medicines during pregnancy is a growing public health concern due to the risk of developmental toxicity. Healthcare providers heavily rely on the FDA pregnancy risk categories (A, B, C, D, and X). Antibiotics are among the most prescribed drugs during pregnancy and are often listed under category B or C. However, the risk-benefit assessment may be lacking due to challenges in the clinical toxicology studies on pregnant women, such as ethical concerns. The primary focus of this study is to generate a model that predicts the safe use of antibiotics during pregnancy by using in silico approaches. Thus, a QSAR model was created to assess the FDA pregnancy category (B or C) of antibiotics. The dataset consisted of 97 antibiotics obtained from the FDA. A total of 6420 molecular descriptors were determined via multiple software and various machine learning algorithms were utilized. The performance of the models was measured using internal and external validation. The accuracy (ACC) values of the most successful model were 83.82% for the internal and 94.11% for the external validation. Sensitivity (SE), specificity (SP), MCC, and ROC values were 0.878, 0.778, 0.68, and 0.892 for the internal validation and 0.9, 1, 0.887, and 0.936 for the external validation, respectively. Kappa statistics also indicate that there was a substantial agreement for internal validation with 0.6765 and an almost perfect agreement for external validation with 0.8811. In conclusion, our model can be used as an initial step before pre-clinical and clinical studies to predict the safe use of antibiotics in pregnancy.