The past two years have not been kind to anyone, but maybe especially pregnant women. Given fears and concerns about the potential risks of contracting Covid while pregnant, and whether or not pregnant women should get the vaccine (spoiler alert: you should), it has been a scary time giving birth to new babies .
But with so many pregnancy fears revolving around Covid in recent years, some may have forgotten that not every cough and runny nose necessarily has to do with Covid. And treating other diseases also requires additional considerations for pregnant women.
Especially when it comes to whether to take antibiotics to treat these infections.
Pregnancy and Antibiotics: Are They Safe?
Lucky Sekhon, MD is a dual certified fertility doctor and OBGYN. She says antibiotics can be safe when taken during pregnancy, depending on the medication itself. And more importantly, like with the Covid-19 vaccine, the benefits of taking antibiotics during pregnancy and potential risks often outweigh the benefits .
“It could be dangerous to under- or not medically treat an infection during pregnancy, as it could turn into a more serious infection,” said Sekhon.
Of course, knowing which antibiotics to take and when is an important part of the equation. According to General Practitioner Navya Mysore, MD, âCertain antibiotics are safe to take during pregnancy, but there is a list that is safe to use during pregnancy, and that list can change depending on how far along you are or how well you are what trimester you are in. â
To keep track of which antibiotics are safe and which are not during pregnancy, the American College of Clinical Pharmacy (ACCP) follows the Food and Drug Administration (FDA) pregnancy category ratings:
- A: Drugs that human studies have shown no risk to the fetus or the pregnant person
- B: Medicines that have shown no risk in animal experiments but have not been tested in human studies and should therefore only be used during pregnancy if there is a clear indication
- C: Medicines that have shown some side effects in animal studies and for which no clear human studies are available. Hence, these drugs should only be used during pregnancy, when there are no better options
- D: Drugs that have shown positive indications of risks in human studies, risks should be fully explained to the pregnant patient before taking (drugs of this category should be avoided during pregnancy if possible)
- X: Drugs that are contraindicated during pregnancy and that may pose a serious risk of fetal abnormalities
It is important to pay attention to these reviews when taking and prescribing antibiotics during pregnancy.
All antibiotics have some potential complications, whether or not a patient is pregnant. But some are generally safer than others. Those in categories A and B have the fewest potential complications for a patient and fetus.
Sekhon said that potential complications ultimately depend on the antibiotic itself.
“There are some that have been shown in animal studies to lead to higher rates of birth defects and cancer that have not been confirmed in human studies,” she said. “Other antibiotics, like streptomycin, are known to pose a risk of hearing loss in babies exposed in utero.”
But there are also antibiotics that fall into these first categories and pose a very low risk of complications. As well as those that are only considered safe in certain trimesters.
As Mysore explained, âThere are some that are safer than others and some antibiotics that are safer in one trimester but not in another. Examples are penicillin and cephalexin (Keflex), which are considered safe in each trimester compared to sulfa antibiotics, which are generally safe in the second and third trimesters but not the first trimester. “
For all of these reasons, it is important for a pregnant person to tell their doctor and pharmacist that they are pregnant before taking any new antibiotics. In this way, they can discuss possible risks together and choose the safest antibiotic.
Discover that you are pregnant while taking antibiotics
Obviously, pregnancy isn’t always planned. And there are occasions when a person may find that they are pregnant while they are already on certain antibiotics.
“I think this would depend on what antibiotic you’re taking and what you’re taking it for,” Mysore said. “If it’s an antibiotic that is safe to use in pregnancy, completing the course won’t hurt.”
But what if it is a drug that is not safe for pregnancy?
“For example, if you’re taking antibiotics to treat acne, it may be a drug you can stop taking as opposed to an antibiotic used to treat urinary tract infections or bacterial sinus infections,” Mysore said. “The bottom line is that I would suggest contacting your GP to make the decision about the medication you are taking.”
However, there is no need to panic. Just pick up the phone and call your doctor as soon as you find out you are pregnant. From there, you can decide together what is the best course of action.
Questions to ask
If you are prescribed antibiotics during pregnancy, asking questions and advocating for yourself and your baby is perfectly acceptable.
“Especially if it isn’t your doctorâs office prescribing the medication, âMysore said.
She recommends asking if the drug has been classified as safe for the trimester you are in. And if it’s a necessary drug, rather than a Category A drug, then you should also ask about the potential risks.
“If your provider is not sure, don’t hesitate to take them back to your OB for an opinion,” she said.
Sekhon agreed, adding, âPregnancy Category C drugs should be avoided and only taken when necessary and the potential risks are outweighed by the benefits. It is also important to know if there is a better alternative antibiotic to switch to. “
The good news is that when it comes to antibiotics, there are often alternatives that can be considered.
“Being pregnant doesn’t mean you have to go without drugs (antibiotics) at all costs,” said Sekhon. “Talk to your doctor about the pros and cons of any medication you might want to take in early pregnancy.”
And take care of yourself while you’re at it. One way to do this, according to Mysore, is to always take a probiotic while you’re taking antibiotics – whether you’re pregnant or not. This can help prevent some of the potential, nasty side effects of antibiotics like yeast infections. Something that nobody wants to deal with, but especially not during pregnancy.