Trimethoprim-sulfonamide combination therapy in early pregnancy.
OBJECTIVE
One of my patients presented with bacteriuria early in her pregnancy. Urine culture was positive for Escherichia coli. I would like to prescribe a trimethoprim-sulfamethoxazole combination because it worked well for her in the past. What is known about the safety of this medication during early pregnancy?


CONCLUSIONS
Evidence-based studies report an association between trimethoprim-sulfonamide combinations in early pregnancy and several major malformations, such as neural tube defects and cardiovascular defects. If clinically possible, physicians are advised to use alternative antimicrobial medications for treatment of urinary tract infections during early pregnancy.
Sivojelezova
Anna
A
Hospital for Sick Children, Toronto, Ont.
Einarson
Adrienne
A
Shuhaiber
Samar
S
Koren
Gideon
G
D000014:Abnormalities, Drug-Induced; D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000075202:Contraindications; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011261:Pregnancy Trimester, First; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects* / Q000627:therapeutic use*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination