Is It Safe To Use Antibiotics When Pregnant?

When you’re pregnant, your health is your top priority, and you want to make sure that every medication you take is safe for both you and your baby, including antibiotics. Find out which antibiotics are safe to use during pregnancy and any potential risks you should know about

There will be several changes to your body after a positive pregnancy test. The thing you didn’t realize, though, is that all those alterations can make for a hospitable environment for infections, which could necessitate the use of antibiotics.

Yet, you can rest easy knowing that the need for antibiotics during pregnancy is rather normal. Over 30% of the more than 13,000 pregnant women questioned in the CDC’s National Birth Defects Prevention Study (NBDPS) took at least one course of antibiotics between three months before conception and the end of their pregnancies, most often at the fourth month.

Fortunately, a wide variety of antibiotics now in use are safe to use while pregnant. Recent studies, however, have shown that the use of some antibiotics during pregnancy can increase the risk of developing a birth defect. This causes concern among parents because they may believe they must choose between giving their child the antibiotic and reducing the likelihood of a congenital condition and not giving the antibiotic, increasing the risk of infection and its complications.

According to experts, the matter is not so black and white. Numerous antibiotic alternatives are safe during pregnancy. Here are some recommendations for keeping you and your infant healthy if you are prescribed antibiotics.

Types of Infections

To begin, understand that infections can originate from various sources, including bacteria, fungi, and viruses. Antibiotics cannot remedy infections caused by viruses. They are not used to treat infections caused by viruses or other germs for which they are ineffective.

Not using antibiotics when they aren’t needed or effective helps prevent the development of drug-resistant bacteria, which can make antibiotics ineffective if and when they are actually needed. To treat infections that aren’t caused by bacteria, it may be necessary to try a different approach. Yet, antibiotics are highly effective when treating bacterial infections.

Pregnancy-Related Bacterial Infections

UTIs and group B strep are two of the most common bacterial infections that pregnant women experience. Antibiotics are the only medicines that will help you recover from these illnesses. Therefore you should take them even though they may harm your unborn child.

Why? According to Dr. Komal Bajaj, an OB-GYN and reproductive geneticist in New York City, in some situations, not treating your infection could be significantly more hazardous for your baby’s health than exposing them to an antibiotic.

There are certain antibiotics that should be avoided during pregnancy, and your obstetrician will know which ones they are in order to provide the antibiotics with the best safety records.

Antibiotic Use During Pregnancy

Dr. Bajaj warns that pregnant women should not be alarmed by the word “antibiotic” alone. Antibiotics are an integral element of our clinical practice, yet, it is wise to exercise caution. Dr. Bajaj explains that if you do have a bacterial illness, your doctor will take great care in deciding which antibiotic to treat you.

Drug Classifications by The FDA For Use During Pregnancy

Many drugs are perfectly safe to take while pregnant, but some can pose substantial risks to the unborn child. The FDA’s Pharmaceutical Pregnancy Category informs clinicians (and their pregnant patients) on which medications are safe to take during pregnancy. A, B, C, D, and X are the several groups available. Here are the descriptions of the different categories to help you figure out what’s going on.

  • Category A: Proven safe for pregnant women.
  • Category B: Animal studies failed to demonstrate fetal toxicity; there are no adequate human investigations.
  • Category C: Animal studies indicate detrimental effects on the fetus, or there is no animal or human research available.
  • Animal studies indicate a higher danger to the fetus in category D, although the benefits may outweigh the risks.
  • Category X: Animal studies demonstrate a definite risk but no benefits.

Pregnant women can safely take medications classified as Category A, while those in Category X pose a risk to the developing baby. All the other groups can be found in the middle ground. Drugs in category B have been proven safe in animal tests and are generally accepted as safe for human consumption. Drugs in Category C have been shown to cause harm in animal research, but there is insufficient data from human trials to draw firm conclusions. Category D includes substances that have been shown to raise the risk of harm to human babies, but their use during pregnancy may be necessary for particular situations.

Ask your doctor about the pregnancy category of any medications you are taking if you are pregnant or trying to get pregnant. A medication’s package insert will also list its pregnant safety category.

What are the possible risks?

Anencephaly (a fatal skull and brain malformation), choanal atresia (blockage of the nasal passage), congenital heart disorders, transverse limb deficiency, eye defects, diaphragmatic hernia, and cleft palate are all examples of congenital disorders defined within Category X that are linked to antibiotic use.

Drugs in Categories A and B

Pregnancy Category A drugs must have a substantial quantity of reliable evidence, although many common Category B drugs, such as the antibiotic Augmentin, can be taken safely by pregnant women (amoxicillin and clavulanate).

Sinusitis and pneumonia are two examples of bacterial illnesses that can be dangerous to a pregnant woman and her unborn child if left untreated; Augmentin is routinely used to treat both conditions. According to Dr. Aleksandr M. Fuks, an OB-GYN in New York City, the medicine has been studied extensively in animal reproduction and appears to have no harmful effect on pregnancy.

The National Birth Defects Prevention Project revealed no link between penicillin, the most commonly used antibiotic during pregnancy, and an increased risk of about 30 different congenital diseases.

Facts about how drugs are ranked for safety.

Dr. Fuks claims that many medications lack sufficient and well-controlled studies since it would be unethical to conduct trials on pregnant women. Certain medications in Category B, for instance, could have unrecognized adverse effects on the fetus.

“Medications should only be provided in instances when the health care professional strongly believes that the benefit of its use greatly surpasses any possible hazards to the fetus and the pregnancy,” Dr. Fuks advises.

Although antibiotics like penicillin have been used safely for decades, doctors are being forced to employ a larger variety of antibiotics due to the rise of resistant germs. The antibiotic kind, dosage, and duration of usage all play a role in determining whether or not they are safe to use during pregnancy.

Rationalizing heightened dangers.

Although there may be a small likelihood of harm, even if an antibiotic has been related to an increased incidence of congenital abnormalities. About 1 in 4,200 pregnancies will result in a child with hypoplastic left heart syndrome. The National Center on Birth Defects and Developmental Disabilities reports that the use of sulfonamide antibiotics increases the risk of having a child born with a birth defect by a factor of three, to roughly 1 in 1,400.

Antibiotic Use During Pregnancy: What You Need to Know

Most people agree that it’s safe to use antibiotics during pregnancy. These include, but are not limited to:

  • Ampicillin
  • Augmentin
  • Amoxicillin
  • Erythromycin
  • Penicillin
  • Clindamycin
  • Cephalexin

Antibiotics are generally avoided during pregnancy for a variety of reasons, and some of the most prevalent ones are:

  • Bactrim
  • Doxycycline
  • Septra
  • Tetracycline
  • Ciprofloxacin
  • Minocycline

Pregnancy And the Use of Azithromycin And Clarithromycin

Researchers looked into the possibility of a connection between the use of macrolide antibiotics like azithromycin and clarithromycin during pregnancy and the development of a congenital condition in the fetus, and their findings were published in the journal Pharmacoepidemiology and Drug Safety.

Researchers evaluated the results of pregnant women who had taken macrolides, penicillin, or no antibiotics, using data from approximately 135,000 women in the Quebec Pregnancy Cohort (nonbinary persons were not included in this data).

Study author Anick Bérard, Ph.D., said, “We did not find a link between taking macrolides during pregnancy and the risk of birth defects that were statistically significant.” For the treatment of infections during pregnancy, this is encouraging.

Azithromycin is considered a Category B medicine by the FDA, meaning it has been proven to be safe in animal trials. Category C drugs, like clarithromycin, have been demonstrated to have harmful consequences in animal studies. Although there are no well-controlled trials in humans on either group, information is being gathered to look for an uptick in the rates of congenital abnormalities in children delivered to mothers who took the medicines while pregnant.

See a Physician

While dealing with an infection, it’s important to talk things over with your doctor. Always inform or remind your healthcare provider that you are pregnant or trying to conceive when getting prescription medications or medical care, and discuss any medications you are already taking with them to reduce the risk of negative drug interactions.

Dr. Fuks advises patients to tell their doctors about any allergies they may have as well as any preexisting diseases, including kidney disease, liver disease, a history of hepatitis or jaundice, or mononucleosis. Your doctor should also be notified if you have any adverse reactions to the medication or if the infection does not improve.


Although it may be worrying to think about taking medicine while pregnant, many antibiotics are thought to be safe for both you and your developing child. Infections are a major cause for concern during pregnancy and should be treated immediately. You should talk to your doctor if you have any concerns or questions. Nonetheless, rest assured that your doctor will select the most risk-free medicine option available to ensure the well-being of you and your unborn child.

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