title: A Review of Antibiotic Use in Pregnancy.
abstract: During pregnancy, untreated sexually transmitted or urinary tract infections are associated with significant morbidity, including low birth weight, preterm birth, and spontaneous abortion. Approximately one in four women will be prescribed an antibiotic during pregnancy, accounting for nearly 80% of prescription medications in pregnant women. Antibiotic exposures during pregnancy have been associated with both short-term (e.g., congenital abnormalities) and long-term effects (e.g., changes in gut microbiome, asthma, atopic dermatitis) in the newborn. However, it is estimated that only 10% of medications have sufficient data related to safe and effective use in pregnancy. Antibiotics such as beta-lactams, vancomycin, nitrofurantoin, metronidazole, clindamycin, and fosfomycin are generally considered safe and effective in pregnancy. Fluoroquinolones and tetracyclines are generally avoided in pregnancy. Physiologic changes in pregnancy lead to an increase in glomerular filtration rate, increase in total body volume, and enhanced cardiac output. These changes may lead to pharmacokinetic alterations in antibiotics that require dose adjustment or careful monitoring and assessment.
authors.affiliation: Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, South Carolina.
authors.forename: P Brandon
authors.initials: PB
authors.lastname: Bookstaver
authors.affiliation: Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Savannah, Georgia.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Bland
authors.affiliation: Department of Pharmacy Practice, Midwestern University Chicago College of Pharmacy, Downers Grove, Illinois.
authors.forename: Brooke
authors.initials: B
authors.lastname: Griffin
authors.affiliation: Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, Mississippi.
authors.forename: Kayla R
authors.initials: KR
authors.lastname: Stover
authors.affiliation: Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Meridian, Mississippi.
authors.forename: Lea S
authors.initials: LS
authors.lastname: Eiland
authors.affiliation: Department of Pharmacy Practice, Midwestern University Chicago College of Pharmacy, Downers Grove, Illinois.
authors.forename: Milena
authors.initials: M
authors.lastname: McLaughlin
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic therapy; pharmacokinetics; pregnancy; teratogenicity