Antibiotics during pregnancy: Are they safe?

I am 25 weeks pregnant and got a bad case of the flu. I now have an upper respiratory infection and my doctor wants to treat it with antibiotics. Are these safe for me to take?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Most upper respiratory infections are viral in origin and antibiotics will have no effect. The medical community is trying to reduce the frequency of prescriptions for antibiotics as well as choose types which are less broad in their application. Microbial resistance poses a major threat to the public health and to future generations.

We have known for years that babies whose mother receive certain antibiotics are at higher risk for fungal or yeast infections after birth as well as dehydration from drug induced diarrhea. Healthy full term babies usually do well despite these occurrences, but stressed or preterm babies often do not.

In a recent issue of the American Journal of Obstetrics and Gynecology, it was reported that an astounding 46% of the mothers in the study received some type of antibiotic during their pregnancies or during labor. Babies who were exposed to these medications had a decreased ability to fight off infection. Almost half of them were resistant to Ampicillin, a commonly used broad spectrum antibiotic.

Protocols do vary from site to site but routine antibiotics are generally given to mothers in labor if they have had a positive culture for group B beta strep during their pregnancy or if they are in preterm labor. Such medications are also given to mothers if rupture of membranes has occurred and the baby is not delivered by 18 hours after this event.

Other indications for antibiotic use is maternal fever, fetal heart rate over 160 or malodorous amniotic fluid. The study points out that antibiotics should not be withheld from such mothers but the authors felt that such usage could be reduced by at least five percent. They suggest that penicillin and similar drugs should be the antibiotics of choice. These drugs kill fewer organisms than broad-spectrum antibiotics such as ampicillin, so there is a reduced risk that infants will develop antibiotic resistance.

I would recommend that you ask your care provider to justify the use of such medications in the light that most upper respiratory infections are viral in nature and will therefore not respond to antibiotics.

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