Antibiotics in Pregnancy

OK

  • penicillins
  • cephalosporins
  • clindamycin
  • erythromycin
  • azithromycin
  • SMX/TMP in SECOND TRIMESTER ONLY
    • Avoid TMP in 1st trimester (folate antagonist)
    • Avoid SMX in 3rd trimester (kernicterus risk)
  • nitrofurantoin 
    • Avoid in last month (risk of hemolytic anemia)

CAUTION

  • nitrofurantoin 
    • small risk, but short courses (e.g., BV, trich) likely OK
  • doxycycline likely OK in short courses

NO

  • fluoroquinolones
  • tetracyclines
    • except doxycycline – does not bind to Ca matrix, OK to use for RMSF
  • clarithromycin
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