Bluer asked
What antibiotics can you use during pregnancy?
Answer
There are a variety of antibiotic medications that can be used and are considered safe to use while pregnant. I will just give some generalized statements on some classes of drugs for your reference. If you have a specific drug you want to ask about, please do and we can give a more specific answer!
Antibiotic Classes And Safety During Pregnancy
Macrolide Drugs (Erythromycin, Clarithromycin, Azithromycin): These are generally safe in pregnancy but most prescribers will avoid using clarithromycin in pregnancy due to concerns of birth defects in animal studies.
Penicillins: Generally OK
Cephalosporins: Generally OK
Macrobid (Nitrofurantion): Nitrofurantoin is typically okay during pregnancy and breastfeeding. It is recommended to avoid it close to delivery due to a small chance of hemolytic anemia in the newborn.
Bactrim (TMP/SMX): Bactrim should usually be avoided. Trimethoprim may cause birth defects during the 1st trimester may cause high bilirubin and jaundice in the baby if given near term.
Metronidazole: Metronidazole is often avoided in the 1st trimester due concerns about possible malformations. It is however commonly used if there are no good alternatives.It should not be used while breastfeeding for 12 to 24 hours to allow the drug be eliminated.
Clindamycin: Clindamycin is usually considered OK and is an alternative to metronidazole for anaerobic bacteria coverage.
Fluoroquinolones (ciprofloxacin, etc): These are associated with cartilage damage in animals in both studies and real life experience. Even though this isn't confirmed in humans, it is recommended to avoid fluoroquinolones during pregnancy.
Tetracyclines (Minocycline, tetracycline etc.): These should be avoided in pregnancy, especially in the 2nd and 3rd trimester. They're associated with adverse effects on fetal teeth and bones and can cause maternal liver toxicity.
Vancomycin: This drug is usually okay during pregnancy. It's not teratogenic and the risk for kidney or hearing problems is very low.
Fluconazole: should usually be avoided during the 1st trimester due to possible birth defects with doses of 400 mg or higher but a single 150 mg dose does NOT seem to be harmful during pregnancy or breastfeeding.
