[Antimicrobials and pregnancy].
The physiologic changes that occur during pregnancy result in pharmacokinetic changes that can alter the effectiveness of antimicrobial agents. The possible risk of teratogenic and toxic effects of antimicrobials on the fetus is an additional cause of concern. In general, pregnant women are excluded from clinical trials and there is little pharmacokinetic information on the use and proper dosing of antimicrobials in this population. Although most antimicrobials can cross the placental blood barrier, data on the potential teratogenic effects, and fetal and neonatal toxicity caused by antimicrobials are also limited and of varying reliability. This article reviews the available evidence with the greatest clinical relevance regarding the pharmacology of different antibiotic, antifungal, antiviral, and antiparasitic agents in pregnancy, with particular focus on data related to fetal toxicity.
Vallano
Antonio
A
Servicio de Farmacología clínica, IDIBELL, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España. avallano@bellvitgehospital.cat
Arnau
Josep Maria
JM
D000014:Abnormalities, Drug-Induced / Q000209:etiology / Q000517:prevention & control; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000977:Antiparasitic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000075202:Contraindications; D005260:Female; D005333:Fetus / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome
D000900:Anti-Bacterial Agents; D000977:Antiparasitic Agents; D000998:Antiviral Agents