What Are The Permitted Antibiotics In Pregnancy?

Can pregnant women take antibiotics? There are antibiotics safe during pregnancy? What to do when the pregnant woman has an infection and needs treatment?

With the increasing prevalence of chronic diseases and the expansion of the arsenal of antibiotics to treat infections, it is increasingly common to use of drugs during pregnancy. Although feared, not every medication taken during pregnancy is necessarily dangerous. In many situations, as in the cases of infections, medications are necessary for the well-being of the mother and the fetus. A case of urinary tract infection in pregnant, for example, is much more damaging to the fetus than the possible adverse effects of antibiotics (read: urinary tract infection in pregnancy).

We must not forget, however, that about 3% of fetal malformations are still caused by the misuse of drugs during pregnancy, especially when these are administered in the first trimester, when the fetus is in formation.

In this article we will do a quick review on the benefits and dangers of the use of fashion in pregnancy.

Antibiotics Are Bad?

Before we talk about specifically the prescription of antibiotics in pregnancy, we must first bring down some myths about the use of antibiotics in General.

The advent of antibiotics was one of the largest revolutions of mankind. Diseases that have milhões people over the centuries have been easily controlled with a treatment that is, in many cases, in taking pills for 7 or 10 days. Nowadays no one else cares about an epidemic of bubonic plague and life-threatening diseases, such as syphilis and tuberculosis, despite still being frequent, feature a dramatically lower mortality rate than in the early 20th century.

Antibiotics are, in principle, extremely beneficial drugs to the population. The problem with antibiotics arises when the your use is done indiscriminately or little judicious. Just like any medicine, antibiotics should only be prescribed when there is a clear indication. To prescribe an antibiotic, the doctor needs to know the your spectrum of antimicrobial action, their mechanisms of action, your profile of adverse effects, their contraindications and microbial resistance profile of your community. If they are respected all the care, antibiotics will bring more benefits than harm to patients.

In the case of pregnant women, the doctor needs to know also what are antibiotics safe for the developing fetus.There are antibiotics that can be used safely at any time in pregnancy, but there are also those who are proven to be harmful to an unborn baby. If you followed the guidelines, there’s no need to be afraid of taking antibiotics during pregnancy. Many of the antibiotics in pregnancy are already used for decades without having been identified severe malformation.

To know a little more about antibiotics in General, access the following link: antibiotics | types, resistance andindications

Classification Of Medicines During Pregnancy

Just like any other drug, antibiotics also receive a classification according to the your potential risk to the fetus.The most common way to rate the safety of drugs in relation to pregnancy is through FDA classification, American Agency of medicines:

Category → medicines properly studied in humans, which doesn’t reveal problems in the first trimester of pregnancy and there is no evidence of problems in the second and third quarters.

Category B → medicines without adequate studies in humans, but that the experience in animals showed no risks or medication with adverse effects in animals, but which, when studied in humans, do not show scratches.

Category C → medicines without adequate studies in humans, but the animals experience demonstrated a risk to the fetus. In these cases, potential beneficial effects of treatment may be greater than the risks, justifying your use in pregnancy in specific situations.

Category D → medications with appropriate studies in humans that demonstrate evidence of risk to the fetus. Should only be indicated in pregnancy in cases of serious diseases for which it cannot use safer drugs.

Category X → medicines with adequate human studies showing abnormalities in the fetus. Do not use under any circumstances during pregnancy.

There are several other ways to classify the fetal risk of medicines, the FDA was chosen table in this article for being one of the most common and simple.

Antibiotics During Pregnancy

Let’s list alphabetically the main antibiotics and your classification of risk. When necessary, I will make some observations.

To facilitate understanding, the drugs that fall into categories A and B are those commonly used in pregnancy. In the case of antibiotics, no drugs classified in category a. antibiotics used in pregnant women are those of category B, but that’s not a problem, because it is not expected that these drugs cause problems in the fetus.

Category C drugs are eventually used, in General, in specific situations, when the drug is needed and there are no alternatives in category A and B.

Drugs classified as category D are contraindicados in pregnancy, and your use is only supported in extreme situations, when the infection is at high risk for the fetus and there are no safer drugs available. In normal situations it is not acceptable for an antibiotic prescription in category D for pregnant women.

The drugs classified as category X are those known to cause malformations and in no situation to your prescription is accepted.

List Of Antibiotics  Category Of Risk In Pregnancy

Amikacin- Category D

Amoxicillin- Category B

Amoxicillin + clavulanic acid- Category B

Azithromycin- Category B

Cephalotin- Category B

Cefazolin- Category B

Ceftriaxone- Category B

Cefuroxime- Category B

Ciprofloxacino- Category C

Clarithromycin- Category C

Clindamycin – Category B

Chloramphenicol- Category C

Doxycycline- Category D

Erythromycin- Category B

Streptomycin- Category D

Fosfomycin- Category B

Gentamicin- Category D

Levofloxacin- Category C

Metronidazole- Category B *

Metronidazole is contraindicated (category X) in the first quarter. From the second quarter, it can be used in pregnant women.

Minocycline- Category D

Neomycin- Category D

Nitrofurantoin- Category B

 The nitrofurantoin is contraindicated (category X) from the 38th week of pregnancy because it is related to a high risk of hemolytic anemia in the newborn.

Norfloxacin- Category C

Ofloxacin- Category C

Oxacillin- Category B

Penicillin g benzathine- Category B

Penicillin V- Category B

Piperacilina + Tazobactam- Category B

Primaquine- Category C

Rifampin- Category C

Sulfamethoxazole + trimethoprim- Category D *

In special situations, such as in the treatment of Pneumocystis jirovecii, prophylaxis for Toxoplasmosis encephalitis and treatment of Q fever, the Sulfamethoxazole + trimethoprim may be prescribed in pregnant women.

Tetracycline- Category D

Tobramycin- Category D

Vancomycin- Category B

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