A Review of Antibiotic Use in Pregnancy

  title={A Review of Antibiotic Use in Pregnancy},
  author={P. Brandon Bookstaver and Christopher M. Bland and Brooke L. Griffin and Kayla R. Stover and Lea S. Eiland and Milena M. McLaughlin},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
During pregnancy, untreated sexually transmitted or urinary tract infections are associated with significant morbidity, including low birth weight, preterm birth, and spontaneous abortion. Approximately one in four women will be prescribed an antibiotic during pregnancy, accounting for nearly 80% of prescription medications in pregnant women. Antibiotic exposures during pregnancy have been associated with both short‐term (e.g., congenital abnormalities) and long‐term effects (e.g., changes in… 
Vigilance on use of drugs, herbal products, and food supplements during pregnancy: focus on fosfomycin
  • C. Mannucci, G. Dante, G. Calapai
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2019
Analysis of data from the database of the multicenter study PHYTOVIGGEST confirmed the safety use of fosfomycin use in pregnancy, and analysis of data of pregnancy complicancies did not show any difference in women taking fosFomycin during pregnancy and those not taking it.
Maternal antibiotic use and child asthma: is the association causal?
Maternal antibiotic use before, during and after pregnancy is associated with higher child asthma risk, and lack of specificity to the pregnancy period suggests the association is not causal or the window of susceptibility extends outside pregnancy.
The safety of metronidazole in pregnancy
Metronidazole was found to be effective in preventing preterm births when used in conjunction with other antibiotics, and its use did not predict birth defects or congenital abnormalities, but was associated with a 70% increased risk of spontaneous abortion.
Use of Antibiotic Treatment in Pregnancy and the Risk of Several Neonatal Outcomes: A Population-Based Study
The results suggested an increased risk of several neonatal outcomes in women exposed to ATs during pregnancy, albeit the authors were not able to assess to what extent the observed effects were due to the infection itself.
Applications for Bacteriophage Therapy during Pregnancy and the Perinatal Period
This review aims to provide a thorough overview of studies of this nature and discuss the feasibility of bacteriophage use during pregnancy to treat and/or prevent bacterial infections.
Common Bacterial and Viral Infections: Review of Management in the Pregnant Patient
There are limited data on clinical outcomes in pregnant patients with common bacterial and viral infections, so clinicians should weigh antimicrobial dosing, pharmacokinetics, safety, and established effectiveness to optimize antimicrobial therapy in pregnancy.
Antibiotic use during pregnancy: how bad is it?
It is expected that microbiota manipulation in pregnancy, through the use of probiotics and fecal microbiota transplantation, will be the subject of increasing clinical interest.
Antibiotic use during pregnancy and the risk of preterm birth: a population-based Swedish cohort study
Antibiotic use during pregnancy was associated with an increased risk of preterm birth, especially in mothers with chronic diseases, since a healthy maternal microbiome may be protective.


Safety of antimicrobial treatment during pregnancy: a current review of resistance, immunomodulation and teratogenicity
The extent of antibiotic use in pregnancy remains unknown but may occur in > 40% of pregnant women for various indications, at different gestational ages from different sources, and strong evidence exists to guide clinicians in their choice of a safe agent with respect to teratogenicity.
Drug Treatment for Tuberculosis during Pregnancy
Pyridoxine (vitamin B6) should be added to the drug treatment of tuberculosis in all pregnant women taking isoniazid, and Ciprofloxacin has the best safety profile of second line drugs in the treatment of drug-resistant tuberculosis.
Antibiotics in pregnancy--a prospective cohort study on the policy of antibiotic prescription.
The dosages of antibiotics should probably be individualized more often, according to the information available on the pharmacokinetics of specific antibiotics during pregnancy, and it may also be possible to reduce the length of antibiotic treatment for UTI.
Exposure to nitrofurantoin during early pregnancy and congenital malformations: a systematic review and meta-analysis.
Antiinfective therapy for pregnant or lactating patients in the emergency department.
The use of antiinfective agents in pregnant or lactating women requires consideration not only of the drugs' effectiveness but also their possible effects on the fetus or newborn and the nature of follow-up care.
Effects of Antibacterials on the Unborn Child
After reviewing the evidence-based information from epidemiological studies, it appears that most antibacterial agents can be used relatively safely during pregnancy.
Pharmacokinetics and safety of antimicrobial agents during pregnancy.
Review of the literature suggests that, although the need for caution in the use of antimicrobial agents during pregnancy has been well emphasized, firm data on the pharmacokinetics, efficacy, and optimal use of these drugs in this situation are extremely sparse and urgently needed.
A prospective controlled multicentre study of clarithromycin in pregnancy.
This first prospective controlled study of exposure to clarithromycin in pregnancy suggests that this agent does not increase the rate of major malformations above the baseline risk of 1-3%, but the higher rate of reported spontaneous abortions may warrant further study.
Urinary tract infection in pregnant population, which empirical antimicrobial agent should be specified in each of the three trimesters?
Fosfomycin is considered to be the most adequate first-line treatment regimen for pregnant women with urinary tract infection due to high sensitivity to the drug, ease of use and safety for use in pregnancy.
Fetal Safety of Macrolides
Use of macrolides in the first trimester of pregnancy is not associated with an increased risk of major malformations and exposure in the third trimester is not likely to increase neonatal risks for pyloric stenosis or intussusception in a clinically meaningful manner.