[Antibiotic therapy in pregnancy]

Abstract

Apart from pregnancy-related ascending and hematogenous infections, non-pregnancy-associated may be a potential thread for pregnant women as well as for their unborn children. Infections are one of the causes of abortion during the first trimester, whereas during second and third trimester, they represent the primary cause of preterm birth. Both pregnant women and their physicians may feel profoundly uncertain with regards to appropriate treatment. If antimicrobial agents are indicated, beta-lactam antibiotics are generally safe and effective. With respect to penicillins, an approximately 10 per cent maternal allergy rate should be taken into consideration, and first-generation cephalosporins may be a suitable alternative. Among the macrolide antibiotics, erythromycin should be preferred. Clindamycin, metronidazole, sulfonamides and chloramphenicol may be used as second-line agents, however, sulfonamides and chloramphenicol should be avoided during the prepartal period. Glycopeptide and aminoglycoside antibiotics should be reserved for life-threatening maternal infections refractory to other antibiotics. Tetracyclins may only be used before the 12 (th) week of gestation. Quinolones should be strictly avoided due to potential toxicity for the unborn children.