THE RISKS AND BENEFITS OF ANTIMICROBIAL THERAPY IN PREGNANCY

Antimicrobial agents, especially antibiotics, are prescribed in pregna ncy for various specific indications related to pregnancy per se (e.g. chorioamnionitis), for infections otherwise unrelated to but complica ting pregnancy (e.g. pneumonia, bacterial endocarditis) and prophylact ically for conditions which if untreated would have an adverse outcome for the pregnancy (e.g. asymptomatic bacteriuria). The selection of a n agent will depend on the likely pathogen, stage of pregnancy, specia l pharmacokinetic factors related to the stage of pregnancy, safety of the drug and cost. Some classes of antibiotics can be taken throughou t the 3 trimesters (e.g. beta-lactams), while others are completely co ntraindicated (e.g. tetracyclines) and others are to be avoided in cer tain trimesters (e.g. sulphas are contraindicated in the third trimest er). The choice of an appropriate antimicrobial agent must be weighed against the potential adverse outcome of a particular infection, the d rug safety and spectrum of activity.