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DOI: 10.1055/s-2003-45391
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662
Antibiotics and Other Anti-infective Agents in Pregnancy and Lactation
Publikationsverlauf
Publikationsdatum:
02. Januar 2004 (online)
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ABSTRACT
Serum levels of many drugs are lower in pregnancy compared with the nonpregnant state. Their renal clearance is higher and the maternal intravascular volume is expanded. Most antibiotics are safe for use in pregnancy and lactation. Tetracyclines cause fetal tooth discoloration and inhibition of bone growth if used in the second and third trimesters. Aminoglycosides carry a small risk of fetal ototoxicity. Quinolones may cause arthropathies in children, and so are currently not recommended for use in pregnancy. Most drugs are secreted into breast milk in very small amounts, not enough to have any therapeutic effect. The only antibiotics which may be of concern in nursing infants are sulfonamides and quinolones, and possibly metronidazole.
KEYWORDS
Antibiotics - pregnancy - lactation
REFERENCES
- 1 Heinonen P O, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group 1977: 296-313
- 2 Aselton P, Jick H, Milunsky A, Hunter J R, Stergachis A. First-trimester drug use and congenital disorders. Obstet Gynecol . 1985; 65 451-455
- 3 Heikkila A M, Erkkola R U. The need for adjustment of dosage regimen of penicillin V during pregnancy. Obstet Gynecol . 1993; 81 919-921
- 4 Macaulay M A, Berg S A, Charles D. Placental transfer of dicloxacillin at term. Am J Obstet Gynecol . 1968; 102 1162-1168
- 5 Briggs G G, Freeman R K, Yaffe S J. Drugs in Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 1078
- 6 Briggs G G, Freeman R K, Yaffe S J. Drugs in Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 284
- 7 Kafetzis D, Siafas C, Georgakopoulos P, Papadatos C. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand . 1981; 70 285-288
- 8 Depp R, Kind A, Kirby W, Johnson W. Transplacental passage of methicillin and dicloxacillin into the fetus and amniotic fluid. Am J Obstet Gynecol . 1970; 107 1054-1057
- 9 Briggs G G, Freeman R K, Yaffe S J. Drugs in Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 222
- 10 Czeizel A E, Rockenbauer M, Sorensen H T. et al . Use of cephalosporins during pregnancy and in the presence of congenital abnormalities: a population-based, case-control study. Am J Obstet Gynecol . 2001; 184 1289-1296
- 11 Nathorst-Boos J, Philipson A, Hedman A, Arvisson A. Renal elimination of ceftazidime during pregnancy. Am J Obstet Gynecol . 1995; 172 163-166
- 12 Sheng K T, Huang N N, Promadhattavedi V. Serum concentrations of cephalothin in infants and children and placental transmission of the antibiotic. Antimicrob Agents Chemother . 1964; 10 200-206
- 13 Harris R C, Lucey J F, MacLean J R. Kernicterus in premature infants associated with low concentration of bilirubin in the plasma. Pediatrics . 1958; 21 875-884
- 14 Ylikorkala O, Sjostedt E, Jarvinen P A, Tikkanen R, Raines T. Trimethoprim-sulfonamide combination administered orally and intravaginally in the first trimester of pregnancy: its absorption into serum and transfer to amniotic fluid. Acta Obstet Gynecol Scand . 1973; 52 229-234
- 15 Colley D P, Kay J, Gibson G T. A study of the use in pregnancy of co-trimoxazole and sulfamethizole. Aust J Pharm . 1982; 63 570-575
- 16 Bailey R R. Single-dose antibacterial treatment for bacteriuria in pregnancy. Drugs . 1984; 27 183-186
- 17 Briggs G G, Freeman R K, Yaffe S J. Drugs in Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 1393
- 18 Czeizel A. A case-control analysis of the teratogenic effects of co-trimoxazole. Reprod Toxicol . 1990; 4 305-313
- 19 Hernandez-Diaz S, Werler M M, Walker A M. et al . Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med . 2000; 343 1608-1614
- 20 Jarnerot G, Into-Malmberg M B, Esbjorner E. Placental transfer of sulphasalazine and sulphapyridine and some of its metabolites. Scand J Gastroenterol . 1981; 16 693-697
- 21 Mogadam M. Sulfasalazine, IBD, and pregnancy: reply. Gastroenterology . 1981; 81 194
- 22 Briggs G G, Freeman R K, Yaffe S J. Drugs in Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 1293
- 23 Committee on Drugs. American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001; 108 776-789
- 24 Briggs G G, Freeman R K, Yaffe S J. Drugs in Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 1000
- 25 Hosbach R H, Foster R B. Absence of nitrofurantoin from human milk. JAMA . 1967; 202 1057
- 26 Varsano I, Fischl J, Shochet S B. The excretion of orally ingested nitrofurantoin in human milk. J Pediatr . 1973; 82 886-887
- 27 Kline A H, Blattner R J, Lunin M. Transplacental effect of tetracycline on teeth. JAMA . 1964; 118 178-180
- 28 Cohlan S Q, Bevelander G, Tiamsic T. Growth inhibition of prematures receiving tetracycline. Am J Dis Child . 1963; 105 453-461
- 29 Czeizel A E, Rockenbauer M. Teratogenic study of doxycycline. Obstet Gynecol . 1997; 89 524-528
- 30 Robinson G C, Cambon K G. Hearing loss in infants of tuberculous mothers treated with streptomycin during pregnancy. N Engl J Med . 1964; 271 949-951
- 31 Nishimura H, Tanimura T. Clinical aspects of the teratogenicity of drugs. Amsterdam: Excerpta Medica 1976: 13
- 32 L'Hommedieu C S, Nicholas D, Armes D A, Jones P, Nelson T, Pickering L K. Potentiation of magnesium sulfate-induced neuromuscular weakness by gentamicin, tobramycin, and amikacin. J Pediatr . 1983; 102 629-631
- 33 Czeizel A E, Rockenbauer M, Olsen J. et al . A teratological study of aminoglycoside antibiotic treatment during pregnancy. Scand J Infect Dis . 2000; 32 309-313
- 34 Marynowski A, Sianozecka E. Comparison of the incidence of congenital malformations in neonates from healthy mothers and from patients treated because of tuberculosis. Ginekol Pol . 1972; 43 713-715
- 35 Weinstein A J, Gibbs R S, Gallagher M. Placental transfer of clindamycin and gentamicin in term pregnancy. Am J Obstet Gynecol . 1976; 124 688-691
- 36 Zaske D E, Cipolle R J, Strate R G, Malo J W, Koszalka M F. Rapid gentamicin elimination in obstetric patients. Obstet Gynecol . 1980; 56 559-564
- 37 Yoshioka H, Monma T, Matsuda S. Placental transfer of gentamicin. J Pediatr . 1972; 80 121-123
- 38 Nicolau D P, Freeman C D, Belliveau P P, Nightingale C H, Ross J W, Quintiliani R. Experience with a once-daily aminoglycoside program administered to 2184 adult patients. Antimicrob Agents Chemother . 1995; 39 650-655
- 39 Munckhof W J, Grayson M L, Turnidge J D. A meta-analysis of studies on the safety and efficacy of aminoglycosides given either once daily or as divided doses. J Antimicrob Chemother . 1996; 37 645-663
- 40 Mitra A G, Whitten K, Laurent S L, Anderson W E. A randomized, prospective study comparing once-daily gentamicin versus thrice-daily gentamicin in the treatment of puerperal infection. Am J Obstet Gynecol . 1997; 177 786-792
- 41 Celiloglu M, Celiker S, Guven H. et al . Gentamicin excretion and uptake from breast milk by nursing infants. Obstet Gynecol . 1994; 84 263-265
- 42 Briggs G G, Freeman R K, Yaffe S J. Drugs in Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 502
- 43 Louik C, Werler M M, Mitchell A A. Erythromycin use during pregnancy in relation to pyloric stenosis. Am J Obstet Gynecol . 2002; 186 288-290
- 44 Einarson A, Phillips E, Mawji F. et al . A prospective controlled multicentre study of clarithromycin in pregnancy. Am J Perinatol . 1998; 15 523-525
- 45 Philipson A, Sabath L D, Charles D. Transplacental passage of erythromycin and clindamycin. N Engl J Med . 1973; 288 1219-1221
- 46 South M A, Short D H, Knox J M. Failure of erythromycin estolate therapy in in utero syphilis. JAMA . 1964; 190 70-71
- 47 Briggs G G, Freeman R K, Yaffe S J. Drugs and Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 286-287
- 48 Berkovitch M, Pastuszak A, Gazarian M, Lewis M, Koren G. Safety of the new quinolones in pregnancy. Obstet Gynecol . 1994; 84 535-538
- 49 Pastuszak A, Andreou R, Schick B. et al . New postmarketing surveillance data supports a lack of association between quinolone use in pregnancy and fetal and neonatal complications. Reprod Toxicol . 1995; 9 584
- 50 Briggs G G, Freeman R K, Yaffe S J. Drugs and Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 271
- 51 Beard C M, Noller K L, O'Fallon W M, Kurland L T, Dockerty M T. Lack of evidence for cancer due to use of metronidazole. N Engl J Med . 1979; 301 519-522
- 52 Finegold S M. Metronidazole. Ann Intern Med . 1980; 93 585-587
- 53 Piper J M, Mitchel E F, Ray W A. Prenatal use of metronidazole and birth defects: no association. Obstet Gynecol . 1993; 82 348-352
- 54 Burtin P, Taddio A, Ariburnu O, Einarson T R, Koren G. Safety of metronidazole in pregnancy: a meta-analysis. Am J Obstet Gynecol . 1995; 172 525-529
- 55 Centers for Disease Control. Pregnancy outcomes following systemic prenatal acyclovir exposure: June 1, 1984-June 30, 1993. MMWR Morb Mortal Wkly Rep . 1993; 42 806-809
- 56 Scott L L, Sanchez P J, Jackson G L, Zeray F, Wendel Jr D G. Acyclovir suppression to prevent cesarean delivery after first-episode genital herpes. Obstet Gynecol . 1996; 87 69-73
- 57 Stray-Pedersen B. Acyclovir in late pregnancy to prevent neonatal herpes simplex. Lancet . 1990; 336 756
- 58 Watts H D, Brown Z A, Money D. et al . A double-blind, randomized, placebo-controlled trial of acyclovir in late pregnancy for the reduction of herpes simplex virus shedding and cesarean delivery. Am J Obstet Gynecol . 2003; 188 836-843
- 59 Andrews E B, Yankaskas B C, Cordero J F, Schoeffler K, Hampp S. Acyclovir in pregnancy registry: six years' experience. Obstet Gynecol . 1992; 79 7-13
- 60 Sheffield J S, Fish D N, Hollier L M. Acyclovir concentrations in human breast milk after valacyclovir administration. Am J Obstet Gynecol . 2002; 186 100-102
- 61 Culnane M, Fowler M G, Lee S S. et al . Lack of long-term effects of in utero exposure to zidovudine among uninfected children born to HIV-infected women. JAMA . 1999; 281 151-157
- 62 McGowan J P, Crane M, Wiznia A A. et al . Combination antiretroviral therapy in human immunodeficiency virus-infected pregnant women. Obstet Gynecol . 1999; 94 641-646
- 63 Watts D H. Management of human immunodeficiency virus infection in pregnancy. N Engl J Med . 2002; 346 1879-1891
- 64 Dabis F, Msellati P, Meda N, for the DITRAME Study Group. et al . Six-month efficacy, tolerance, and acceptability of a short regimen of oral zidovudine to reduce vertical transmission of HIV in breastfed children in Côte d'Ivoire and Burkina Faso: a double-blind placebo-controlled multicentre trial. Lancet . 1999; 353 786-792
- 65 Rosa F. Amantadine pregnancy experience [comment; letter]. Reprod Toxicol . 1994; 8 531
- 66 Centers for Disease Control. Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mort Wkly Rep . 2000; 49 1-38
- 67 Briggs G G, Freeman R K, Yaffe S J. Drugs and Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 45
- 68 Briggs G G, Freeman R K, Yaffe S J. Drugs and Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 731
- 69 American Thoracic Society. Treatment of tuberculosis and tuberculosis infection in adults and children. Am J Respir Crit Care Med 1994; 149 1359-1374
- 70 Boggess K A, Myers E R, Hamilton C D. Antepartum or postpartum isoniazid treatment of latent tuberculosis infection. Obstet Gynecol . 2000; 96 757-762
- 71 Briggs G G, Freeman R K, Yaffe S J. Drugs and Pregnancy and Lactation 6th ed. Baltimore: Williams & Wilkins; 2002: 732