Taking antibiotics can be intimidating even for non-pregnant women due to potential side effects. Nevertheless, sometimes you cannot do without them. The main thing is to inform your doctor about your condition so they can choose a medication for you with minimal risks.
Doctors sometimes prescribe antibiotics even when there are no symptoms. What happens if I refuse to take them?
Doctors may prescribe antibiotics after a urine test, even if you don’t notice any symptoms. Up to 15% of pregnant women have asymptomatic bacteriuria [1], a urinary tract infection. If left untreated, you can develop kidney inflammation (pyelonephritis), which may lead to complications and premature birth [1]. So, if you are prescribed antibiotics by your doctor, take them.
Do antibiotics increase the risk of miscarriage?
Not all of them, and not always. Antibiotics such as tetracyclines, sulfonamides, and metronidazole can increase miscarriage risk. But penicillin and cephalosporins are safe [2]. Only a doctor can determine the type, dosage, and form of administration of antibiotics, more so during pregnancy.
Can antibiotics lead to developmental defects in my baby?
Unfortunately, it is a possibility. Macrolide antibiotics pose a higher risk, while penicillin, amoxicillin, nitrofurantoin, and cephalosporins are less risky [3], making them the preferred choice when doctors have to prescribe antibiotics during pregnancy.
Untreated bacterial infections can lead to complications for you and your baby [4], so you have to talk to your doctor and weigh the risks depending on your situation.
Does the risk depend on the trimester in which the antibiotics are taken?
The most risky time to take antibiotics is during the first trimester of pregnancy because the baby’s organs are in early development. When macrolide antibiotics are taken during the first three months, or even right before pregnancy, the likelihood of a heart or genitourinary system defect in the baby will be one and a half times higher than with the use of the same drugs during the second or third trimester [5].
Are local antibiotics safer than pills?
There is no right answer to this question. Everything is different for pregnant women, including the rate of absorption and distribution of medicines. Doctors will be cautious when prescribing oral antibiotics to women who suffer from toxicosis or severe nausea during pregnancy because that makes it difficult to predict how much of the antibiotic is absorbed into the bloodstream, so in some cases, local antibiotics or injections may be prescribed [6]. In any case, only a doctor can prescribe antibiotics, especially during pregnancy.
