The use of penicillins and macrolides during pregnancy does not present any risk of malformation in the baby. They can be prescribed regardless of the term.
Pregnant women treated with antibiotics can be reassured that their babies are not afraid. A large Canadian study published this Friday in the journal Pharmacoepidemiology and Drug Safety confirms that the most prescribed antibiotics, penicillin and macrolides, do not affect the development of the child.
More specifically, researchers at the University of Montreal were interested in macrolides, a class of antibiotics suspected of causing congenital heart defects. Scientists therefore compared the use of this antibiotic to that of penicillin, a treatment very well tolerated by pregnant women.
The researchers relied on health data from more than 135,800 pregnant women and their children collected between 1998 and 2008. In this cohort, no woman received a treatment known to be teratogenic or who had received another antibiotic. than penicilin or macrolides. “Among the women studied, 92% did not receive an antibiotic during their pregnancy, 6.7% received penicillins and 1.7% received macrolides during the first trimester of pregnancy. And we have identified 9.8% of pregnant women who have given birth to a child with congenital heart disease, detail the authors. After statistical analyzes, we found no significant association with this family of antibiotics. “
Frequently used molecules
This is reassuring news for pregnant women who are frequently treated with antibiotics. “The urinary tract infection is the most frequent infection during pregnancy and it is the one which very often justifies the prescription of antibiotics, explains to Why actor Prof. Olivier Graesslin, head of the gynecology-obstetrics department at the University Hospital of Reims. Penicillin is used mainly and as a first line. The duration of antibiotic therapy depends on the profile and type of urinary tract infections. ”
If the germ involved in the infection is not sensitive to penicillin, the doctor adapts the antibiotic treatment. “Macrolides are an alternative to penicillins, especially for people with allergies”, emphasize the authors.
For Olivier Graesslin, the results of the Canadian study confirm the safety of these antibiotics. “We have known for a long time that penicillins do not increase the risk of malformation and that they can be used during pregnancy,” comments Professor Olivier Graesslin. Regarding macrolides, many new molecules are entering the market. It is therefore important to know that they can be used in pregnant women ”.
Others are to be avoided
On the other hand, some studies warn about the malformative risks associated with the consumption of other families of antibiotics such as sulfonamides, quinolones or even cylines. These drugs have very serious side effects such as abnormal cartilage development or kidney dysfunction. In addition, for some molecules the possible effects are not known or no data has established teratogenicity because little research has been carried out.
Listen…Olivier Graesslin, head of the gynecology-obstetrics department at the Reims University Hospital: ” We have records that let us know what kind of medicine can be used during pregnancy, which should be avoided, or which should absolutely be avoided. But in some situations there is only one medicine that is going to be useful and effective in treating and caring for the patient and in those situations you are stuck. “
“To determine which drug can be used or precisely to avoid, guides of good practice and registers exist and allow the doctor to obtain information”, explains the gynecologist. This is particularly the case of the website of the Reference Center on Teratogens (CRAT) written by healthcare professionals, but accessible to all audiences. This also specifies that “the macrolides currently on the market can be used regardless of the term of pregnancy”. It also indicates that the use of penicillins and macrolides is also not a problem when breastfeeding.
.
