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Medications for Infection in Pregnancy

These facts give you the basics about each of the drugs listed. Only the most basic problems are here. Ask your doctor if you need to take any special steps. Use each of these as the way your doctor or the instructions tell you to.

Prescription Medicines

Antibiotics

Antibiotics treat infections caused by bacteria, such as:

Antibiotics kill the bacteria that cause the infection. The infection may still come back. If this happens, a repeat course may be needed. Some people may keep having problems even after the bacteria are killed.

You may be given:

  • Amoxicillin —This is a type of penicillin antibiotic. It comes as a pill or liquid.
  • Clindamycin —Can be used if you have an allergy to penicillin.
  • Ceftriaxone, Cephalexin, Cefazolin —These are cephalosporin antibiotics. Some are given in a pill form and others are injected.
  • Azithromycin, Erythromycin —These drugs are called macrolides. They are used for many kinds of bacterial infections.

Reactions may be:

  • Belly pain
  • Nausea and vomiting
  • Diarrhea
  • Allergy, such as skin rash, swelling, and problems breathing

Immune Globulin

If you have been exposed or have certain infections, you may be given this to help boost your ability to fight infections. IG can be given safely as a shot under the skin, into a muscle, or by IV.

IG can be used for:

  • Chickenpox —Varicella-zoster immune globulin (VZIG) can prevent chickenpox or make the infection less severe if it is given within 72 hours of coming in contact with the virus.
  • Measles —If you were exposed to measles and have not had it before, you may be given IG by IV within six days of coming in contact with the virus.
  • Hepatitis B —Often given late in pregnancy. It has been shown to prevent it from passing from you to your growing baby.
  • Cytomegalovirus (CMV) infection —Immune globulin may help prevent the fetus from getting the infection.

Antiviral Medicines

Infection with herpes virus is treated with acyclovir. This can also be used to prevent an outbreak during pregnancy. Women who have HIV should talk to their doctor about which antiviral medicines are right for them.

Certain antiviral medicines can safely be given to women late in pregnancy to lower the risk of giving hepatitis B to the growing baby. These are lamivudine, telbivudine, and tenovofir.

Antiparasitic Medicines

Toxoplasmosis is a disease that results from an infection by a parasite. It is treated with antiparasitic medicines.

If a pregnant woman has toxoplasmosis but the fetus does not, then the mother may be treated with Spiramycin . This is a macrolide antibiotic and antiparasitic.

If the baby has toxoplasmosis, a mix of these medicines may be prescribed:

  • Pyrimethamine —This is an antimalarial agent.
  • Sulfadiazine —This is a sulfonamide antibiotic that fights the growth of bacteria.
  • Folinic acid —A form of folic acid. It is used to treat toxoplasmosis when given with pyrimethamine and sulfadiazine.

Special Steps

When you take medicines, follow these steps:

  • Take your medicine as directed. Do not change the amount or schedule.
  • Ask what side effects could happen. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your prescription medicine.
  • Medicines can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one, including over the counter products and supplements.
  • Plan ahead for refills.

Over-the-Counter Medicines

Talk with your doctor before using over the counter medicines to treat an infection. There are some that are not safe to use during pregnancy.

Acetaminophen is generally safe to use during pregnancy. It may ease symptoms of an infection. Other pain relievers, such as ibuprofen , naproxen, and aspirin should not be taken during pregnancy unless under medical supervision. These need to be avoided late in pregnancy.

REFERENCES:

Bacterial vaginosis during pregnancy. American Pregnancy Association website. Available at: http://americanpregnancy.org/pregnancycomplications/bacterialvaginosis-2.html. Updated August 2015. Accessed August 13, 2018.

Chickenpox. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T116084/Chickenpox. Updated June 25, 2018. Accessed August 13, 2018.

Chorioamnionitis. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases_conditions/hic_Am_I_Pregnant/hic_Premature_Labor/hic_Chorioamnionitis. Updated October 18, 2012. Accessed August 13, 2018.

Cytomegalovirus (CMV) and congenital CMV infection. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/cmv/index.html. Updated June 6, 2018. Accessed August 13, 2018.

Group B Strep (GBS). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/groupbstrep/index.html. Updated May 29, 2018. Accessed August 13, 2018.

Listeria and pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancyhealth/listeria.html. Updated March 10, 2017. Accessed August 13, 2018.

Measles. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T116399/Measles. Updated April 15, 2016. Accessed October 6, 2016.

Nielsen GL, Sorensen HT, et al. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population based observation study and case-control study. BMJ. 2001;322:266-270.

Parasites—toxoplasmosis (toxoplasma infection). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parasites/toxoplasmosis/gen_info/pregnant.html. Updated March 26, 2015. Accessed August 1, 2016.

Pregnancy and fifth disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parvovirusB19/pregnancy.html. Updated November 17, 2017. August 13, 2018.

Pregnancy and HBV: FAQ. Hepatitis B Foundation website. Available at: http://www.hepb.org/patients/pregnant_women.htm. Updated October 17, 2012. Accessed June 20, 2016.

Shi Z, Li X, et al. Hepatitis B immunoglobulin injection in pregnancy to interrupt hepatitis B virus mother-to-child transmission-a meta-analysis. Int J Infect Dis. 2010;14(7):e622-e634.

STDs during pregnancy. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/pregnancy/default.htm. Updated October 6, 2017. Accessed August 13, 2018.

Toxoplasmosis. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/toxoplasmosis.html. Updated May 1, 2014. Accessed August 13, 2018.

Urinary tract infection during pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/utiduringpreg.html. Updated March 10, 2017. Accessed August 13 ,2018.

Varicella. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us. Updated September 8, 2015. Accessed July 29, 2013.

Wong F, Pai R, et al. Hepatitis B in pregnancy: a concise review of neonatal vertical transmission and antiviral prophylaxis. Ann Hepatol. 2014;13(2):187-195.

Last reviewed May 2018 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG  Last Updated: 8/13/2018