Antibiotics in pregnancy – are they safe?

Expert advice on the safety of penicillin, cephalosporin and other drugs used to treat bacterial infections when pregnant

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In a nutshell

Some antibiotics are not safe for pregnant women to take 

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The expert view

Antibiotics are used to treat bacterial infections and while some are perfectly safe for use by pregnant (or breastfeeding) women, others are not.

Our GP Dr Philippa Kaye says that “whether or not you are pregnant it is important that you only take antibiotics when a doctor feels that it is necessary” and that you should always finish the entire course of medication.

“Some antibiotics are safe in pregnancy and others are not; some are safe for breastfeeding and others are not. As with any medication in pregnancy do tell your doctor that you are pregnant so an appropriate pregnancy safe antibiotic can be prescribed,” she says.

Types of antibiotics

Antibiotics can be broadly classified into six main groups, but there are hundreds of different antibiotics out there – so it’s vitally important that you only take antibiotics that have been prescribed specifically for you by your doctor.

Penicillin – Penicillin is widely used to treat certain infections such as skin infections, chest infections and urinary tract infections and includes drugs like amoxicillin and flucloxacillin.

Cephalosporins – Cephalosporins are used for serious infections like septicaemia and meningitis and include drugs like cefalexin and cefixime. If you are allergic to penicillin you may also be allergic to cephalosporins.

Aminoglycosides – Aminoglycosides are a type of antibiotic that used to be widely prescribed until it was found that they could cause both damage to hearing and the kidneys. Because of this, they tend now to be used only to treat very serious illnesses such as meningitis.

Tetracyclines – Tetracyclines are commonly used to treat moderate to severe acne and rosacea, which causes flushing of the skin and spots. They are not usually recommended for pregnant or breastfeeding women.

Macrolides – Macrolides are a type of antibiotic that can be used for lung and chest infections and can be an alternative for people with a penicillin allergy or to treat penicillin-resistant strains of bacteria. Recent research by Great Ormond Street Hospital in London found that taking macrolide antibiotics in pregnancy may lead to an increased risk of a baby developing cerebral palsy, or epilepsy, later in life.

Fluoroquinolones – Fluoroquinolones are the newest type of antibiotic and can be used to treat a wide range of infections. But, unfortunately, they are not suitable for use by pregnant or breastfeeding women, according to the NHS.

Dr Kaye adds: “The most commonly used antibiotics are probably penicillins, cephalosporins and macrolides. A commonly used antibiotic for urinary tract infections is trimethoprim – this is not safe in pregnancy so for a UTI in pregnancy unless you are pencillin-allergic amoxicillin is generally used. Or for acne – tetracyclines are often used – however these are NOT safe in pregnancy.”

She advises that the critical thing is to make sure your doctor knows you are pregnant, so an “appropriate and pregnancy-safe antibiotic can be prescribed”.

Mums on our forum say

“I’m on antibiotics for a throat infection and I can’t sleep because I can’t breathe through my nose! I am so used to being able to take the maximum dose of ibuprofen and decongestant so I can keep going and not have to resort to going to bed, it hits me hard when I have a bump and can take nothing. I don’t do being ill!” Nicolette

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“I’ve been in and out of hospital with this [kidney infection] as it’s lead to bad infections and the pain’s been so bad I’ve needed morphine injections in my leg. Now I’m on a constant antibiotic I’ve to take every night.” Baby_mama23

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