Antibiotics and Pregnancy
During pregnancy, antibiotics can be used, but only on strict indications, when there is a very good reason for that. This is just the case, which is written in the instruction: "If the expected benefit exceeds the risk for the mother and fetus." In any case, you need to do this only under the strict supervision of the doctor and usually in the hospital (department of pregnancy pathology in the hospital).
In the first trimester, most drugs can harm a developing embryo, so it is better to avoid using antibiotics in this period. The second and third trimesters are safer, but for each medicine there are terms when it can not be used. These subtleties should be well known to your doctor.
Since many bacteria are resistant to antibiotics, it is best to test their sensitivity before starting treatment. The test results will show which bacterium caused the disease and which antibiotic acts best on it.
If the sensitivity test can not be carried out for some reason, the doctor prescribes a broad-spectrum antibiotic, that is, one that kills everyone, if possible.
When Not to do Without Antibiotics
- The most common reasons why antibiotics are prescribed for pregnant women are: a pyelonephritis of pregnant women;
- Inflammation of the lungs, severe bronchitis, tonsillitis;
- Severe intestinal infections;
- Purulent wounds and extensive injuries, burns;
- Severe infectious complications, such as sepsis, blood poisoning;
- Specific diseases caused by rare bacteria: tick-borne borrelliosis, brucellosis, etc.
In all these cases, the use of antibiotics is justified and necessary, in order to avoid even greater complications. That is, the benefit for the mother is much higher than the risk for the fetus.
The main risk of antibiotics is not for the mother, but for her developing baby. Many of them penetrate the placenta into the fetal bloodstream and can have a harmful effect on the organ that is currently most intensively growing.
All antibiotics during pregnancy can be divided into three groups:
1) Prohibited completely, due to the proven toxic effect on the fetus;
2) Allowed, no harmful effect proven;
3) The effect on the fetus has not been studied, so it can only be applied in case of emergency.
Tetracycline, doxycycline - pass through the placenta, accumulate in the bones and dentition of the fetus, disrupting their mineralization. Toxic to the liver.
Fluoroquinolones (ciprofloxacin, ciprolet, nolycin, abaktal, floxal, etc.) are prohibited, no reliable safety studies have been performed in pregnant women. Damage the joints of the fetus in animal studies.
Clarithromycin (klatsid, fromilid, klabaks) - safety of use in pregnancy is not known. There is evidence of toxic effects on the fetus in animals.
Midekamycin, roxithromycin (macropen, rulid) is the same as clarithromycin.
Aminoglycosides (kanamycin, tobramycin, streptomycin) - pass through the placenta, give a high risk of complications on the kidneys and inner ear of the fetus, can cause deafness in the newborn. Gentamicin belongs to the same group, but its use is permitted according to vital indications in strictly calculated dosages.
Furazidine (furamag, furagin), nifuroxazide (erfefuril, enterofuril) - are prohibited in connection with potentially harmful effects, there is no data on safety in pregnant women.
Chloramphenicol (levomycetin, sintomycin, olazol) is prohibited. Rapidly passes through the placenta in high concentrations. Oppresses the fetal bone marrow and disrupts the division of blood cells, especially in late pregnancy.
Dioxydin - is often used in surgical practice for disinfection of wounds. It is forbidden during pregnancy, since a toxic and mutagenic effect on the fetus in animals has been found.
Co-trimoxazole (biseptol, bactrim, groseptol) - all known "biseptol". It consists of two substances: sulfamethoxazole and trimethoprim, which passes through the placenta in high concentrations. Trimethoprim is an active antagonist of folic acid (antivitamin). Increases the risk of congenital malformations, heart defects, slows the growth of the fetus.
Admissible in Extreme Cases
Azithromycin (sumamed, zitrolid, zi-factor, chemomycin) - is used only in case of emergency, for example, with chlamydia infection in pregnant women. Negative effect on the fetus is not revealed.
Nitrofurantoin (furadonin) - possible application only in the second trimester, in the first and third is prohibited.
Metronidazole (clion, trichopolum, metrogil, flagel) - is prohibited in the first trimester, can cause defects in the brain, limbs and genitals in the fetus. In the second and third trimester, application is acceptable in the absence of a safer alternative.
Gentamicin - use is allowed only for life indications (sepsis, blood poisoning) in strictly calculated dosages. When the dose is exceeded, there is a risk that the child may be born deaf.
All of the following drugs can be used during pregnancy. However, we must remember that any antibiotic is a potent medicine and it can not be taken without the appointment of a doctor. After passing the prescribed course, you must come to a second appointment.
Penicillin and its analogues (amoxicillin, amoksiklav, ampicillin) - pass through the placenta, but the harmful effect on the fetus, as a rule, is absent. When pregnancy is excreted by the kidneys at an accelerated pace.
Cephalosporins - cefazolin, cefalexin, ceftriaxone, cefuroxime, cefixime (suprax), cefoperazone, cefotaxime, ceftazidime, cefepime - are used in pregnancy without restrictions. Pass through the placenta in low concentrations. Negative effect on the fetus is not revealed.
Erythromycin, as well as josamycin (vilprafen) and spiramycin (rovamycin) - are acceptable for use. Pass through the placenta in low concentrations. Do not cause violations of fetal development and congenital anomalies.
Antibiotics are drugs that destroy bacteria in the human body. They are, for example, penicillin and tetracycline. Analgin, aspirin, arbidol, as well as substances designed to fight microbes in the external environment, before getting into the morning (iodine, zelenka, chlorhexidine), do not belong to antibiotics.
Antibiotics only act on bacteria, against viruses and fungi, they are powerless, and with prolonged admission may even provoke fungal diseases such as candidiasis. Often bacteria are resistant to the prescribed antibiotic, and then the doctor has to choose another medication for treatment.
In addition to the useful action - the destruction of harmful microbes - antibiotics have many side effects. Often these are toxic chemicals that adversely affect the liver. Many antibiotics, especially from the gentamicin group, have the ability to affect kidney and inner ear cells, as well as other organs.
In addition, most antibiotics act indiscriminately on harmful and beneficial microorganisms, killing both. As a result, the body is deprived of protection from beneficial bacteria, living, for example, on the skin or in the intestines - there is a rash, dysbiosis, loose stool and other side effects. At the same time, harmful microbes often survive, because over many years of antibiotic use they have developed resistance to it.
Even worse is that sometimes harmless bacteria can get harmful properties under the influence of antibiotics. Such new strains (varieties of microbes) most often live inside hospitals, and are distributed by the employees themselves - living on their skin, nose and tp. places. The most dangerous of them (for example the infamous MRSA - methicillin-resistant Staphylococcus aureus) often prove to be resistant even to the newest and strongest antibiotics.