Anbx in pregnancy

Q: 24 years old female at 28 weeks gestation is admitted to ICU with urosepsis. Which of the following antibiotics should not be used? (select one)

A) Meropenem

B) Fosfomycin 

C) Nitrofurantoin 

D) Trimethoprim-sulfamethoxazole

E) Fluoroquinolones 

Answer: E

Ideally, fluoroquinolones should not be used in pregnancy (choice E).

Penicillins, cephalosporins, carbapenems (choice A), and fosfomycin (choice B) are considered safe in pregnancy.

Nitrofurantoin (choice C) can be used after the first trimester but may fail to achieve good concentration in renal tissues and may not be effective.

Trimethoprim-sulfamethoxazole (choice D) should also be avoided during the first trimester and in the near term. There is a potential risk of kernicterus in the near term.

#Ob-gyn

#ID

References:

1. Bookstaver PB, Bland CM, Griffin B, et al. A Review of Antibiotic Use in Pregnancy. Pharmacotherapy 2015; 35:1052.

2. Ailes EC, Gilboa SM, Gill SK, et al. Association between antibiotic use among pregnant women with urinary tract infections in the first trimester and birth defects, National Birth Defects Prevention Study 1997 to 2011. Birth Defects Res A Clin Mol Teratol 2016; 106:940.

3. Le J, Briggs GG, McKeown A, Bustillo G. Urinary tract infections during pregnancy. Ann Pharmacother 2004; 38:1692.