Antibiotics once thought harmful to children in utero now deemed safe by
obstetricians, gynecologists
Committee on Obstetric Practice. Obstet Gynecol. 2011;
117:1484-1485.
Crider KS. Arch Pediatr Adolesc Med. 2009;163:978-85.
The National Birth Defects Prevention Study released in
2009 reported that sulfonamides and nitrofurantoins were associated with
several birth defects when taken in the first trimester and called for
additional scrutiny. This week, a new committee opinion issued by the American
College of Obstetricians and Gynecologists reports that these antibiotics are
considered appropriate when an alternative is unavailable.
“Antibiotics are commonly prescribed during
pregnancy for a variety of bacterial infections, so there is considerable data
now on the relationship of antibiotic exposure to birth defects,”
William H. Barth Jr., MD, chair of American College of Obstetricians and
Gynecologists’ committee on obstetric practice, said in a press release.
Regarding the 2009 study, Barth also said the study had
several significant limitations, including patient recall bias, adding that
because it was an observational study, it is impossible to know whether the
birth defects were caused by the antibiotic, the infection itself or some other
factor.
After the first trimester, when the potential risk for
these two antibiotics to cause birth defects is lessened, these antibiotics can
be used as first-line agents for the prevention of urinary tract infections and
other infections, according to the committee opinion statement. As with all
patients, antibiotics should be prescribed for pregnant women only for
appropriate indications and for the shortest effective duration, according to
the statement.