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| |    Commonly Used Antibiotics in Pregnancy by Marjorie Greenfield, M.D. reviewed and revised by Marjorie Greenfield, M.D. Women in the childbearing years are commonly treated with antibiotics and other anti-microbial medications. In pregnancy, the issue of which medication to use comes up frequently, whether for a bladder infection, yeast vaginitis, sinus infection, herpes, or other conditions. Obstetricians frequently get calls from women who were prescribed something by another physician, calls from dentists, and calls from other doctors checking to be sure that a particular antibiotic is OK to use during pregnancy. In this article, I will review commonly used anti-microbial medications. I will not include medications that are given by vein or are used only in rare instances. For information on those sorts of medications, and for information about your individual risks and benefits for any medication, you should speak to your practitioner. In general, every medication is assigned to a category (B, C, D, or X) based on how safe or risky it is to use during pregnancy. To learn more about general principles of medication use in pregnancy, see Medications in Pregnancy. Category A Only a few medications fall into category A, which means that human studies have shown no evidence of fetal harm in the first trimester or later in the pregnancy. Nystatin vaginal (Mycostatin) Category B Most antibiotics are Category B, which means that there is no known association with birth defects or other pregnancy-related complication and the drug is probably safe. These include: Amoxicillin Ampicillin Augmentin (amoxicillin-clavulanate) Dicloxicillin Macrobid (nitrofurantoin) Flagyl (metronidazole) (although there is some controversy about taking it by mouth in the first trimester) Cephalosporins including: Keflex (cephalexin), Ceclor (cefaclor), Duricef (cefadroxil) Cleocin (clindamycin) Erythromycin (all forms) Zithromax (azithromycin) Sulfa drugs (until near term) Famvir (famciclovir) Zovirax (acyclovir) Valtrex (valacyclovir) Clotrimazole-vaginal (Mycelex, Lotrimin) Category C Others are Category C, meaning that either there isn't enough information or there are some concerns arising from animal studies, but no confirmation of problems like birth defects in humans. These include: Bactrim Trimethoprim Biaxin (clarithromycin) Cipro (ciprofloxacin) Diflucan (fluconazole) Monistat (miconazole) Terazol (terconazole) Isoniazid Rifampin Vermox (mebendazole) Tetanus booster (tetanus toxoid) Vaccines: hepatitis A, hepatitis B, influenza, meningococcus, pneumonia (pneumococcus), polio Vaccines: Measles, Mumps, Rubella (in this category because there is no proof that the MMR vaccine causes birth defects, but it is never purposefully used during pregnancy because there is some fear that the rubella component could adversely affect an unborn child) Category D Category D medications have clear-cut problems in pregnancy and should not be used unless there are no better alternatives. Category D includes: Tetracycline derivatives, which can cause discoloration of teeth: tetracycline, doxycycline (Vibramycin), Minocin (minocycline) Sulfa drugs - if near delivery (because they can increase the chance of serious newborn jaundice)
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