Antibiotics and Pregnancy

Can I take antibiotics while I am pregnant?!

There are many oral antibiotics that are considered safe to use while pregnant.  In general penicillins (amoxicillin, Augmentin), cephalosporins (Keflex, Omnicef) and clindamycin are safe antibiotics.

Bactrim (TMP/SMX) has been shown safe in the second trimester of pregnancy.  In my experience, physicians often use this in the second and third trimester.  But definitely avoided in the first trimester.

Nitrofurantoin is often used in the first and second trimester but avoided in the third.  If you want more information about nitrofurantoin -we have 2 articles about nitrofurantoin use during pregnancy –article 1 then follow up article 2.

Flagyl (metronidazole) is usually avoided in pregnancy because concern for fetal malformations.  But it is sometimes used for treatment of bacterial vaginosis and trichomoniasis.  That is because these require short courses of antibiotics that have not been shown to hurt the fetus.  Doxycycline is also usually avoided but is sometimes used in short courses when there are no other alternatives.

Macrolides (azithromycin, clarithromycin and erythromycin) are usually NOT used.  But if needed, azithromycin and erythromycin are better options.

In general quinolones (Cipro, Levaquin) and tetracyclines are NOT  used in pregnancy.  This is because in animal studies quinolones were shown to cause cartilage damage.  And tetracyclines can cause tooth staining and bone issues in kids/babies/fetuses.

Do you have any tips or questions?  We would love to hear from you! Please leave a comment!!

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