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Antibiotics in the first trimester of pregnancy

 If you were prescribed antibiotic treatment in the first trimester of pregnancy, you should not panic. Among modern antibacterial agents, there are safe ones that are approved for use even in the early stages of gestation. What are these drugs? And what antibiotics are prohibited during gestation and why? Let's tell you more.

Antibiotics inhibit the growth of bacteria, the cause of infectious diseases. Usually, doctors try to avoid prescribing them during pregnancy, especially in the 1st trimester, but unfortunately, it also happens that they cannot be dispensed with. In what cases is their use justified? Can they negatively affect the child? What are the consequences of antibiotic treatment? We will try to answer all these questions, dispel fears and prejudices.

In what cases can not do without antibiotic therapy

During pregnancy, the body's immune defenses weaken. This is a natural mechanism that helps to keep the fetus, because it is a foreign element for the immune system. Therefore, a woman during the gestation period is not immune from diseases, and even more than that, she is at risk for ARVI and other infectious diseases. You can not do without antibiotics for such pathologies as:

  • pneumonia, tuberculosis;
  • purulent tonsillitis, acute bronchitis;
  • inflammatory infection in the kidneys, genitourinary system, intestines;
  • chlamydia;
  • blood poisoning;
  • brucellosis;
  • burns and extensive wounds with pus.

In the absence of proper treatment, a woman's health and life are at risk. Therefore, the use of antibiotic therapy is justified. It is also necessary during the rehabilitation period after surgical interventions during pregnancy, as well as caesarean section. The preparations are selected taking into account the level of danger for the woman and the child, the duration of pregnancy, the lactation factor, etc.

Why antibiotics are dangerous during pregnancy in the 1st trimester

From 1 to 12 weeks, all organs of the child are laid and formed: heart, brain, lungs, liver, thyroid and pancreas, rudiments of arms and legs, genitals, digestive, respiratory and circulatory systems.

That is why, if possible, the doctor will always try to postpone antibacterial treatment for 2 or 3 trimesters, replacing it with symptomatic therapy or topical drugs. Taking antibiotics in the 1st trimester is justified if the benefits outweigh the possible risks. After all, the placenta has not yet been formed, which means that the embryo is not protected from the negative effects of drugs.

Uncontrolled use of antibiotics has a toxic effect and can cause:

  • intrauterine growth retardation;
  • congenital infections and anomalies in the structure of organs;
  • hearing and vision impairments;
  • miscarriage;
  • fetoplacental insufficiency.

Therefore, only a doctor can select an antibiotic after a thorough diagnosis and analysis for sensitivity to a particular antibacterial agent. In addition, among the whole variety of drugs, you can choose those that are approved for use during pregnancy.

What antibiotics can pregnant women in the first trimester

All drugs undergo special safety studies, according to the results of which they can be divided into 5 groups:

  1. Group A - absolutely safe, as confirmed by controlled studies involving pregnant women.
  2. B - do not affect the fetus according to the results of animal testing, experiments on humans have not been conducted.
  3. C - Animal studies have shown the possibility of adverse effects on the fetus, no human studies have been conducted, but the potential benefit of the drug may justify the risk of its use.
  4. D - there is evidence of an adverse effect on the human fetus, obtained as a result of research or in practice.
  5. X - in the course of clinical trials, violations in the development of the fetus were detected, the risk of use during gestation outweighs the potential benefit.

Among the antibiotics, there are no those that would belong to group A. Therefore, during gestation, a specialist can prescribe drugs of group B or C. These include penicillins, cephalosporins and macrolides.

List of antibiotic drugs allowed in the 1st trimester

PreparationsAzlocillin, Amoxicillin, Ampicillin, OxacillinCefuroxime, Cefazolin, Cefotaxime, Cefaclor, CefepimeErythromycin, Azithromycin, Josamycin
Security categoryBBB
What are they effective against?Staphylococci, enterococci, streptococci, listeria, clostridia and meningitis caused by them, salmonellosis, skin infections, inflammation of the tonsils, bronchi.Meningitis, urinary and respiratory tract infections, sepsis, skin lesions.Skin pathologies, pneumonia, chlamydia, gonorrhea, mycoplasmosis, Helicobacter pylori infection on the background of stomach ulcers, toxoplasmosis.
How do they affect the fetusPenetrate through the placenta, but do not damage the organs and systems of the fetus.Able to pass through the placenta in low concentrations that are not dangerous for the unborn baby.There is no evidence of an increase in the number of congenital anomalies.
Side effects in pregnancyAnemia, allergies, headache, stool disorders.Vomiting, diarrhea or constipation, cholestasis, anemia, leukopenia.Allergic reaction, indigestion, liver dysfunction, nausea and vomiting.

Penicillins are highly effective against staphylococci and are used in preparation for operations with a preventive purpose. 3rd and 4th generation cephalosporins cope well with gonococci, pneumo- and meningococci, are successfully used by specialists to treat women during pregnancy and during the rehabilitation period after cesarean section, since they do not affect lactation.

Josamycin is indispensable for the treatment of chlamydia, gonorrhea and syphilis in pregnant women. Erythromycin is the only one that does not penetrate into breast milk, therefore it is absolutely safe for breastfeeding.

The choice of agent depends on the results of the analysis for sensitivity to antibiotics. Only in emergency cases is it possible to take broad-spectrum drugs.

What is strictly prohibited

It is categorically impossible to include the following groups of antibiotics in the treatment of diseases before the 12th week of gestation:

  • Carbapenems, since there is confirmed evidence of their teratogenic effects in animals.
  • Clarithromycin, related to macrolides, is prohibited during pregnancy, as it is toxic to the embryo.
  • Tetracyclines - accumulate in the bone tissues of the child, have a harmful effect on the liver, disrupt the mineralization of the teeth.
  • Aminoglycosides - in high concentrations cross the placenta and have a toxic effect.
  • Fluoroquinolones - disrupt the development of cartilage tissue.

These antibiotics in the first trimester of pregnancy can cause spontaneous abortion, fetal fading and genetic mutations. Taking them at a later date will not cause the death of the child, but will provoke serious health problems for the newborn.

Many drugs are not approved for use in pregnant women because there have been no controlled studies on their safety. These are Nitrofurans, Quinolones, Glycopeptides.

I took antibiotics when I didn't know I was pregnant: what to do

Most likely, this happened before 3-4 weeks of gestation. In these terms, it is difficult to accurately predict the effect of antibiotics. On the one hand, the placenta is not yet formed, and the embryo is defenseless against the effects of negative factors. But at the same time, it still develops outside the common blood flow with the mother, so the antibiotic simply cannot “get” to it.

In any case, this is not a reason to terminate the desired pregnancy. However, we recommend that you still inform the doctor about the treatment, do an additional ultrasound and take an hCG test in order to identify possible violations in the dynamics of the development of the embryo.

Planning for pregnancy after antibiotics

If a woman or her partner underwent antibiotic therapy, then conception should be postponed for 3 months. During this time, the remnants of drugs will completely leave the body, the immune system will get stronger, and the pregnancy will proceed without complications.

What not to forget

  • Antibiotics do not act on viruses, therefore, with the usual uncomplicated SARS, their use is not justified, even at high temperatures.
  • Watch your dosage. By reducing it for the sake of reducing risks, you harm yourself: pathogenic bacteria “get used” to the antibiotic and lose sensitivity to it.
  • Talk to your doctor about the need to take it together with probiotics and substances that normalize digestion, because stool disorders during pregnancy against the background of antibiotic therapy are not uncommon.
  • Even if you had to undergo antibiotic therapy during pregnancy, do not despair. Stress will only aggravate your overall health. Modern medicines have a small list of side effects and minimally affect the unborn child.

Let us remind you once again that self-selection and taking antibiotics during the gestation period is unacceptable! In order not to harm yourself and your unborn child, on the selection of any medicines, be sure to consult with a gynecologist observing pregnancy.