USE OF ANTIBIOTICS DURING PREGNANCY

Objective: To describe the occurrence and distribution of antibiotic t reatments, in addition their indications in control pregnant women in the population-based large dataset of the Hungarian Case-Control Surve illance of Congenital Abnormalities, 1980-1996. Results: Of 38 151 con trol pregnant women who delivered later newborn infants without congen ital abnormality, 6554 (17.2%) were treated by antibiotics. Most women (14.5%) had penicillin, while 1.2% and 0.7% of pregnant women were tr eated by cephalosporins and tetracyclines, respectively. More than 100 pregnant women used the following antibiotics: ampicillin (6.9%), pen amecillin (5.9%), cefalexin (1.0%), phenoxymethylpenicillin (0.6%), ox ytetracycline (0.5%), erythromycin (0.45%), benzylpenicillin-procain ( 0.4%) and benzylpenicillin+benzylpenicillin-procain (0.3%). Different antibiotics had different indications for treatment. The mean birth we ight was significantly lower in the treated group compared to the untr eated group. Practical implications: Different antibiotics have differ ent chemical structures and indications for treatment. Therefore it is not appropriate to evaluate their teratogenic potential of combined a ntibiotic groups. There may be many interactions between underlying ma ternal diseases, other drug uses, further confounding factors and anti biotics studied, thus adequate controls are needed to estimate the adj usted teratogenic odds-risk ratios. European countries have different spectrum of antibiotic use. It would be necessary to know these baseli ne data of different populations. The anxiety and fear created by the notion that nearly all drugs cause congenital abnormalities may be mor e harmful than some proven human teratogenic drugs themselves. Thus a better risk-benefit estimation for antibiotic uses during pregnancy is an urgent and important task. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.