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by Lewy J

Medications for Infection in Pregnancy

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. Some options to treat infections during pregnancy include:

Prescription Medications

Antibiotics
Antibiotics treat infections caused by bacteria. Infections caused by bacteria include:
Antibiotics kill the bacteria that cause the infection. The infection may reoccur after using the antibiotics. If this happens, a repeat course of antibiotics may be necessary. Some people may continue to develop symptoms and complications of the infection even after the bacteria are killed.
Below are examples of antibiotics used to treat infections in pregnancy.
  • Amoxicillin —This is a type of penicillin antibiotic. It comes as a capsule, a tablet, a chewable tablet, and a suspension (liquid).
  • Clindamycin —If you are taking the liquid form of clindamycin, use a specially marked measuring spoon to measure each dose correctly. The average household teaspoon may not hold the right amount of liquid.
  • 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 a variety of bacterial infections.
Possible side effects of all antibiotics include:
  • Abdominal pain or discomfort
  • Nausea and vomiting
  • Diarrhea
  • Allergic reaction, including skin rash, swelling, and difficulty breathing
Immune Globulin
If you have been exposed or have specific infections, you may get an injection or infusion of immune globulin (IG) to help boost your immunity. 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 exposure.
  • Measles —If you were exposed to measles and have no signs of immunity, you may be given IG by IV within 6 days of exposure.
  • Hepatitis B —Often given late in pregnancy. It has been shown to prevent transmission from you to your developing baby.
  • Cytomegalovirus (CMV) infection—Immune globulin may help prevent the fetus from contracting the infection.
Antiviral Medications
Infection with herpes virus is treated with acyclovir. This medication can also be used to prevent an outbreak during pregnancy. Women who are infected with HIV should talk to their doctor about which antiviral medications are appropriate.
Certain antiviral medications can safely be given to women late in pregnancy to decrease the risk of transmitting hepatitis B from the mother to the developing baby. These include lamivudine, telbivudine, and tenovofir.
Antiparasitic Medications
Toxoplasmosis is a disease that results from an infection by a parasite. It is treated with antiparasitic medications.
If a pregnant woman has toxoplasmosis but the fetus does not, then the mother may be treated with spiramycin. Spiramycin is a macrolide antibiotic and antiparasitic.
If the fetus or newborn has toxoplasmosis as well, a combination of the following medications may be prescribed:
  • Pyrimethamine—This is an antimalarial agent used to treat toxoplasmosis.
  • 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 combined with pyrimethamine and sulfadiazine.
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
  • Give the medication as directed. Do not change the amount or the schedule.
  • Do not stop giving prescription medication without talking to the doctor.
  • Do not share prescription medication.
  • Ask what results and side effects to expect. Report them to the doctor.
  • Some medications can be dangerous when mixed. Talk to a doctor or pharmacist if your child is taking more than one medication. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you do not run out.
Over-the-Counter Medications
Talk with your doctor before using over-the-counter medications to treat an infection. There are some over-the-counter medications 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 be avoided during pregnancy unless under medical supervision. These medications especially 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 June 20, 2016.
Chickenpox. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T116084/Chickenpox. Updated September 8, 2015. Accessed October 6, 2016.
Chorioamnionitis. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases%5Fconditions/hic%5FAm%5FI%5FPregnant/hic%5FPremature%5FLabor/hic%5FChorioamnionitis. Updated October 18, 2012. Accessed June 20, 2016.
Cytomegalovirus (CMV) and congenital CMV infection. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/cmv/index.html. Updated July 28, 2010. Accessed June 20, 2016.
Group B Strep (GBS). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/groupbstrep/index.html. Updated May 23, 2016. Accessed June 20, 2016.
Listeria and pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancyhealth/listeria.html. Updated August 2015. Accessed June 20, 2016.
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%5Finfo/pregnant.html. Updated March 26, 2015. Accessed August 1, 2016.
Pregnancy and HBV: FAQ. Hepatitis B Foundation website. Available at: http://www.hepb.org/patients/pregnant%5Fwomen.htm. Updated October 17, 2012. Accessed June 20, 2016.
Pregnancy and fifth disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parvovirusB19/pregnancy.html. Updated November 2, 2015. 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 February 24, 2016. Accessed June 20, 2016.
Toxoplasmosis. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/toxoplasmosis.html. Updated May 2014. Accessed June 20, 2016.
Urinary tract infection during pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/utiduringpreg.html. Updated August 2015. Accessed June 20, 2016.
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.

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