Are Antibiotics safe in pregnancy and lactation?

Not only gynecologists and obstetricians are faced with the problem of pharmacotherapy of diseases during pregnancy. Pyoinflammatory diseases in pregnant women are the problems, wide range of specialists is involved into – from physicians to surgeons of different specializations. In the era of a widespread, and sometimes even excessive, usage of antibiotics the question whether their use during gestational period is justified or not is of a great importance.


Pregnancy increases the toxic effects of some drugs produced on the mother’s body changing drugs pharmacokinetics. Some antibiotics can be very toxic for the fetus – many antibiotics can cross placenta and penetrate into the bloodstream of the fetus causing harmful effect on the organ which is most rapidly growing at the moment – and the safety of others has not been proven yet. And still antibiotics are one of the most commonly prescribed during pregnancy type of drugs.


The most common causes of antibiotics usage in pregnant women are:

   -pyelonephritis.

   -pneumonia, acute bronchitis, quinsy (Flagyl, Amoxil or Zithromax can be prescribed by the doctor depending on the indications).

   -severe enteric infections.

   -septic wounds and major traumas, burns.

   -severe infectious complications, such as sepsis or blood poisoning.

   -specific diseases caused by uncommon bacteria: Lyme borreliosis, brucellosis, etc.


Each year FDA receives about 300-400 thousand reports from doctors concerning any serious side effects provoked by this or that drug. Based on these reports every year several drugs are being withdrawn from the market as dangerous ones. Therefore, FDA has prepared the system of risk categories of drugs according to which each drug gets corresponding pregnancy category:


A – safe drugs as per results of the human studies, unfortunately, there are too few drugs in this category;


B – these are rather safe drugs, studies in animals have not shown any harmful side effects caused to the fetus (Amoxil, Cefobid, Zithromax, Zmax, Flagyl and others);


C – there is no data about the safety or the studies have revealed some negative effects on the fetus. But these drugs can be administered to pregnant women considering the benefits and risks caused (Amikin, Primaxin and others);


D – the studies have shown fetal risk, but potential benefits may justify the usage of the drug in spite of potential risks, should be used very carefully during pregnancy (Gentamicin, Kanamycin, Doxycycline and others);


X – these drugs cause irreversible and severe fetal abnormalities, they are contraindicated in pregnant women (Grifulvin V and others).


But still, all antibiotics without any exceptions should be used very carefully if you’re pregnant. And the potential benefits should always be substantially higher than the risks of any fetal abnormalities. Never take any drugs without seeing your doctor first!