Antibiotics and Other Anti-infective Agents in Pregnancy and Lactation

Jennifer R. Niebyl

doi:10.1055/s-2003-45391

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2003; 20(8): 405-414
DOI: 10.1055/s-2003-45391

REVIEW ARTICLE

Antibiotics and Other Anti-infective Agents in Pregnancy and Lactation

Jennifer R. Niebyl

Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa

Abstract

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

Volltext

Referenzen

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