What Antibiotics Can You Take While You’re Pregnant?

A healthcare professional might prescribe antibiotics during pregnancy to treat bacterial infections. Treating infections is important for the health of both you and your fetus. If you’re pregnant, it’s important to know which medications are safe and which ones you should avoid. About 80% of medications prescribed during pregnancy are antibiotics. Since they’re so common, it’s natural to have questions about antibiotics and pregnancy.

Bacterial infections shouldn’t be left untreated during pregnancy. They can cause negative effects for both you and your fetus. And there are several antibiotics that are considered safe to take if you’re expecting.

How Antibiotics Affect the Fetus

Determining which medications are safe during pregnancy has a lot to do with the placenta. It’s an organ your body makes after you become pregnant that does a few different jobs. It allows nutrients to get to the fetus. It also helps remove waste from the fetus. In short, the placenta acts as a filter between you and your fetus. Antibiotics are known to go through the placenta and reach the fetus.

Some antibiotics are still considered safe even though they cross the placenta. But others aren’t safe at all or they’re only safe at certain stages of pregnancy.

Safe Antibiotics and Those to Avoid

Many antibiotics, such as amoxicillin (Amoxil), are considered safe to take during pregnancy. Notable examples include amoxicillin and cephalexin. However, you should avoid certain antibiotics, like tetracyclines and fluoroquinolones, in pregnancy. You should only take them if they’re your only practical option. If you took an unsafe antibiotic before you knew you were pregnant, contact your healthcare team right away.

Research on Macrolide Antibiotics

Macrolide antibiotics (such as azithromycin, clarithromycin, and erythromycin) are used for the treatment of common bacterial infections, such as upper and lower respiratory infections and sexually transmitted diseases, and are frequently used as alternatives for patients allergic to penicillin. Macrolides are among the most commonly prescribed antibiotics during pregnancy in the United States and in European countries.

In a nationwide cohort study, the use of macrolide antibiotics in pregnancy was not associated with an increased risk of major birth defects. Analyses of the associated risk of 12 specific subgroups of birth defects with the use of macrolides in pregnancy were not significant. The study examined 1,192,539 live birth pregnancies to examine the association between the use of macrolide antibiotics in pregnancy and the risk of major birth defects.

Comparison of Birth Defect Risks

Based on the nationwide register based cohort study, the following data was observed:

• Macrolide group: 457 infants were born with major birth defects (35.1 per 1000 pregnancies).
• Penicillin group: 481 infants were born with major birth defects (37.0 per 1000 pregnancies).
• Relative risk ratio: 0.95 (95% confidence interval 0.84 to 1.08).
• Absolute risk difference: −1.8 per 1000 pregnancies.

The risk of major birth defects was not significantly increased for women who had used macrolides during pregnancy compared with those who had used macrolides recently but before becoming pregnant or compared with women who did not use any antibiotics.