title: Evidence-based antimicrobial therapy in pregnancy: long overdue.
abstract: Little evidence exists to guide the clinician caring for pregnant patients with infectious morbidities. The already-small pool of evidence shrinks rapidly as the pathogen becomes more exotic, making therapeutic decisions increasingly speculative when emerging infectious diseases appear in the pregnant patient. The current drug approval mechanisms, legal environment, and profit-driven drug pipeline have combined to exclude pregnant women from clinical trials, paradoxically resulting in a dangerous situation for pregnant women around the world.
authors.affiliation: Department of Obstetrics and Gynecology and Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, Texas, USA. rntheile@utmb.edu
authors.forename: R N
authors.initials: RN
authors.lastname: Theiler
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D012254:Ribavirin / Q000627:therapeutic use; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000890:Anti-Infective Agents; D000998:Antiviral Agents; D012254:Ribavirin
references.citation: PLoS Med. 2008 Jun 17;5(6):e133
references.pmid: 18563964
references.citation: Infect Dis Clin North Am. 2008 Dec;22(4):755-772
references.pmid: 18954762
references.citation: MMWR Morb Mortal Wkly Rep. 2009 May 15;58(18):497-500
references.pmid: 19444154