Antibiotics in Pregnant or Nursing Patient

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During pregnancy, antibiotics should be used with caution. Selection for an antibiotic for pregnant or nursing women must be made with equal consideration for mother and child. Antibiotics with systemic effects cross the placenta and reach the fetus.

For example, tetracycline given during the later part of pregnancy may slow down bone growth, alter enamel formation, and result in permanent tooth discoloration. In addition, many antibiotics appear in the milk of lacting females. However, no adverse effects have been reported with the most commonly used antibiotics during pregnancy.


Risks of Antibiotic Use in Pregnancy and Lactating Women

Drug GroupCrosses placenta or enters brest milkSafe for pregnant or lactating womenRisks
Penicillin yes yes diarrhea in infant, sensitization in infant
Cephalosporin yes yes (relatively limited information) diarrhea in infant
Sulfonomides yes no kernicterus in infant, risk with G-6-PD deficiency
Aminoglycosides yes yes (with caution) diarrhea in infant and possible ototoxicity
Tetracycline yes no affects bone and teeth
Clindamycin yes yes (with caution) drug concentrated in fetal bone, spleen, lung, and liver
Chloramphenicol yes no "Gray syndrome" associated with death in infant at term
Erythromycin yes no intrahepatic jaundice in mother
Metronodazole yes no theoratical carcinogenic data in animals
Vancomycin yes no limited information
Streptomycin yes no congenital deafness

Please refer to the Contraindications and Adverse Reactions section under individual drugs for further information.


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