Commonly Used Antibiotics During Pregnancy - 2000

 


Agent Risk Category Fetal effects Maternal effects Excretion route Half-life T 1/2 (h)
Considered Safe          
Natural penicillins (e.g. penicillin G) B None Known Allergic Renal 0.5
Aminopenicillins (e.g., ampicillin) B None Known Allergic, rash in 5 to 7% Renal 1.0
Antistaphylococcal (e.g., nafcillin) B None Known Allergic Renal, hepatic 0.5
Antipseudomonal (e.g., ticarcillin) B None Known Allergic Renal 1.2
Extended spectrum (e.g. piperacillin) B None Known Allergic Renal 1.0
Cephalosporins (1st, 2nd, 3rd, 4th generations) B None Known Allergic, bleeding if methylthiotetrzole, side chain Renal, hepatic 0.5 to 0.8
Erythromycin (base, stearate or ethylsuccinate) B None Known GI upset, allergic Hepatic 2.0 to 4.0
Clindamycin B None Known Pseudomembranous colitis Hepatic 2.4
Spectinomycin B None Known Allergic Renal 2.0

Probably safe-use with caution

         
Azithromycin B None Known Occasional GI upset Hepatic 68
Aztreonam B None Known Rash, elevated serum transaminases Renal 2.0
Gentamicin C None Known, but ototoxicity reported with other aminoglycosides Increased neuromuscular blockade Renal 2.0
Imipenem-cilastatin C None Known Allergic, rarely seizures Renal 1.0
Metonidazole B None Known GI symptoms, reversible neuropathy, intolerance to alcohol Renal 8.0
Nitrofurantoin B None Known Hemolysis if G6PD deficiency present, neuropathy Renal 0.3 to 1.0
Sulfonamides B; D at term Hemolysis if G6PD deficiency present; avoid at term Allergic Renal Variable
Trimethoprim C Folate antagonism, possibly teratogenic; avoid in 1st trim Allergic Renal 11.0
Vancomycin C None Known Allergic, hearing loss rarely, hypotension if given too rapidly Renal 6.0

Contraindicated

         
Tetracyclines D Discoloration of decidual teeth; inhibiton of bone growth GI symptoms, hepatotoxicity, renal failure Renal 8.0 to 19.0
Fluoroquinolones C Insufficient information in humans; arthropathy reported in immature animals Rare Renal, hepatic 4.0 to 8.0
Streptomycin, kanamycin D Eighth cranial nerve damage Ototoxicity, nephrotoxicity Renal 2.0 to 3.0
Erythromycin estolate B None Known Hepatotoxicity Hepatic 2.0 to 4.0

 


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