Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks

Obstetrics and Gynecology
Gerard G NahumDianne L Kennedy

Abstract

Over ten million women are either pregnant or lactating in the United States at any time. The risks of medication use for these women are unique. In addition to normal physiologic changes that alter the pharmacokinetics of drugs, there is the concern of possible teratogenic and toxic effects on the developing fetus and newborn. This article reviews the risks and pharmacokinetic considerations for 11 broad-spectrum antibiotics that can be used to treat routine and life-threatening infections during pregnancy and lactation. Information from the U.S. Food and Drug Administration (FDA) product labels, the Teratogen Information Service, REPROTOX, Shepard's Catalog of Teratogenic Agents, Clinical Pharmacology, and the peer-reviewed medical literature was reviewed concerning the use of 11 antibiotics in pregnant and lactating women. The PubMed search engine was used with the search terms "[antibiotic name] and pregnancy," "[antibiotic name] and lactation," and "[antibiotic name] and breastfeeding" from January 1940 to November 2005, as well as standard reference tracing. One hundred twenty-four references had sufficient information concerning numbers of subjects, methods, and findings to be included. The teratogenic potential in human...Continue Reading

References

Jul 2, 1977·Lancet·I Rocker
Sep 17, 1977·Lancet·J S Steen, D M Stainton-Ellis
Sep 1, 1977·The Journal of Infectious Diseases·A Philipson
Apr 1, 1976·American Journal of Obstetrics and Gynecology·A J WeinsteinM Gallagher
Jan 1, 1976·Acta Obstetricia Et Gynecologica Scandinavica·S Kullander, B Källén
Jan 1, 1976·Clinical Pharmacology and Therapeutics·A PhilipsonD Charles
Dec 30, 1991·The American Journal of Medicine·J S Wolfson, D C Hooper
Jul 1, 1990·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·T GilbertC Merlet-Benichou
Nov 30, 1989·The American Journal of Medicine·H GiamarellouP Sfikakis
Oct 1, 1989·American Journal of Obstetrics and Gynecology·M P ReyesW Rintelmann
Sep 1, 1988·Journal of the American Academy of Dermatology·K F Rothman, P E Pochi
Jan 1, 1988·British Journal of Clinical Pharmacology·I MathesonA Prentice
Mar 1, 1987·Early Human Development·M R Holdiness
Jan 1, 1987·Developmental Pharmacology and Therapeutics·H Nau
Mar 1, 1985·Journal of Dental Research·T RebichB Brustman
May 1, 1985·Reviews of Infectious Diseases·A W Chow, P J Jewesson
Sep 1, 1985·American Journal of Obstetrics and Gynecology·L M Hill
Nov 1, 1985·Postgraduate Medical Journal·N LazebnikA Aviram
Dec 1, 1985·American Journal of Obstetrics and Gynecology·S G McNeeleyP V Dilts
May 1, 1968·Teratology·K D Courtney, D A Valerio
Oct 1, 1974·Postgraduate Medicine·H Vorherr
Jun 7, 1973·The New England Journal of Medicine·A PhilipsonD Charles
Feb 1, 1974·Toxicology and Applied Pharmacology·J A BollertR N Weaver
Jan 1, 1972·The Journal of Pediatrics·H YoshiokaS Matsuda
Apr 1, 1972·Toxicology and Applied Pharmacology·J E GrayE S Feenstra
Aug 1, 1971·Toxicology and Applied Pharmacology·H Fritz, R Hess
Jan 1, 1970·Acta Paediatrica Scandinavica. Supplement·O Wasz-HöckertP A Järvinen
Jan 1, 1968·Chemotherapy·J HavelkaJ Procházka
Dec 1, 1966·American Journal of Obstetrics and Gynecology·R E BrayW L Johnson
Jan 1, 1966·The Medical Journal of Australia·B F Stratford
Jan 1, 1966·Toxicology and Applied Pharmacology·V DezulianG Maffii
Mar 1, 1984·Archives of Internal Medicine·D E Snider, K E Powell
Nov 1, 1984·Clinical Pharmacokinetics·M R Holdiness
Nov 1, 1980·The American Review of Respiratory Disease·G L Snider, J E Rinaldo
Jan 1, 1981·Drug Metabolism Reviews·M T Kenny, B Strates
Jan 1, 1981·Acta paediatrica Scandinavica·D A KafetzisC J Papadatos
Jul 31, 1995·American Journal of Medical Genetics·S A Hulton, B S Kaplan
Nov 1, 1994·Fundamental and Applied Toxicology : Official Journal of the Society of Toxicology·R A ByrdM K Buening
Jan 1, 1996·Gynecologic and Obstetric Investigation·L AlmeidaS Bergström
Nov 1, 1996·European Journal of Obstetrics, Gynecology, and Reproductive Biology·C SchaeferP Merlob
Nov 4, 1996·Neuroreport·O DeguineM Imbert
Apr 1, 1997·Obstetrics and Gynecology·A E Czeizel, M Rockenbauer

❮ Previous
Next ❯

Citations

Sep 4, 2010·Archives of Gynecology and Obstetrics·Ioannis Mylonas
Sep 28, 2007·Current Treatment Options in Cardiovascular Medicine·Reema Chugh
Jul 31, 2013·Current Treatment Options in Cardiovascular Medicine·Reema Chugh
Dec 3, 2010·Journal of Crohn's & Colitis·Gert Van AsscheUNKNOWN European Crohn's and Colitis Organisation (ECCO)
Jun 29, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·G PentheroudakisUNKNOWN ESMO Guidelines Working Group
Aug 5, 2008·Clinical Obstetrics and Gynecology·Kristy Ward, Regan N Theiler
Sep 17, 2013·PloS One·Westyn Branch-EllimanSharon B Wright
Dec 31, 2010·Indian Journal of Anaesthesia·Anjan Trikha, Pm Singh
Apr 5, 2011·The American Journal of Tropical Medicine and Hygiene·Kathrine R TanUNKNOWN Centers for Disease Control and Prevention
Apr 8, 2014·World Journal of Gastroenterology : WJG·Vivian W Huang, Flavio M Habal
Feb 4, 2014·Enfermedades infecciosas y microbiología clínica·Rosa Polo RodríguezMaría Isabel González Tomé
Jan 25, 2014·Emerging Infectious Diseases·Dana Meaney-DelmanUNKNOWN Workgroup on Anthrax in Pregnant and Postpartum Women
Jan 7, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Catherine LiuUNKNOWN Infectious Diseases Society of America
Dec 22, 2006·Expert Review of Anti-infective Therapy·William J Ledger
Aug 12, 2014·International Journal of Environmental Research and Public Health·Begoña Martinez de Tejada
Jan 1, 2008·Expert Review of Clinical Pharmacology·Andrew VallelyDaniel Chandramohan
Dec 19, 2015·Expert Opinion on Drug Safety·Ruby CrossDaniel H Paris
Apr 7, 2010·Expert Opinion on Drug Metabolism & Toxicology·Hyunyoung Jeong
Feb 25, 2009·Expert Opinion on Drug Safety·Francesco SalvoGiovanni Polimeni
Jan 10, 2013·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·S A BrownW F Rayburn
Apr 24, 2010·Journal of Travel Medicine·Urban Hellgren, Lars Rombo
Feb 21, 2009·Paediatric and Perinatal Epidemiology·William O CooperWayne A Ray
Jun 19, 2010·Journal of Veterinary Pharmacology and Therapeutics·M Martinez, S Modric
Feb 17, 2015·British Journal of Haematology·Toby A EyreGraham P Collins
Nov 26, 2013·Blood·Dragana Milojkovic, Jane F Apperley
May 14, 2016·MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports·Holly M BiggsMarc S Traeger
Feb 27, 2013·Molecular Pharmaceutics·Amal A AkourPhillip Gerk
Sep 21, 2016·Scientific Reports·Rebekah C KennedyJiangang Chen
Oct 28, 2009·Progress in Neurobiology·Urs Meyer, Joram Feldon
Apr 12, 2017·Birth Defects Research·Lisa M Noguchi, Richard H Beigi
Apr 29, 2014·Foot & Ankle Specialist·Nelya Lobkova, Edwin W Wolf
Feb 2, 2008·Digestion·Christian MottetChristian Felley
Aug 22, 2017·MCN. the American Journal of Maternal Child Nursing·Alexis B DunnNicole S Carlson
May 9, 2008·AORN Journal·Deborah Dumphy
Aug 21, 2012·Birth Defects Research. Part A, Clinical and Molecular Teratology·Jean D BrenderUNKNOWN National Birth Defects Prevention Study
Feb 2, 2008·Obstetrics and Gynecology·Kristen A MattesonMaureen G Phipps
Apr 17, 2007·Alcoholism, Clinical and Experimental Research·Marta Yanina PepinoJulie A Mennella
Dec 16, 2017·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Zumrut DoganYusuf Turkoz
Apr 22, 2018·The European Respiratory Journal·Keely LoewenMeghan B Azad
Mar 6, 2019·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Márió Gajdács
Oct 3, 2013·Obstetrics and Gynecology·Dana Meaney-DelmanDenise J Jamieson

❮ Previous
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