Antibiotika-Therapie in der Schwangerschaft: teratogene Risiken von Makroliden, Doxycyclin und Cotrimoxazol
LicenseStandard (Fassung vom 03.05.2003)
Drug exposure during first trimester of pregnancy ranges from 10 % in Germany to 50 % in the USA. Antibiotics are among the most commonly used substances. Objective was to investigate possible teratogenic risks of some currently used antibiotics. Data were collected prospectively by following up pregnant women, who had been counselled on the use of erythromycin, rorithromycin, clarithromycin, azithromycin, doxycycline or co-trimoxazole in first trimester of pregnancy by the Teratology Information Service of the University of Ulm, now located at the Krankenhaus St. Elisabeth Ravensburg. Women who were not exposed or were exposed to evidentially non-teratogenic agents served as controls. They were matched for maternal age and gestational age at call and compared by using Fisher´s exact test. No significant differences were found concerning exposure to erythromycin (n = 41), roxithromycin (n = 163), clarithromycin (n = 131), azithromycin (n = 105), doxycycline (n = 435) and co-trimoxazole (n = 356) in the rates of spontaneous abortions, congenital anomalies and birth weights relating to gestational age at birth. However, the rates of congenital anomalies after exposure to erythromycin and roxithromycin tended to be significantly higher: 8.3 vs. 0 % (p = 0.11) and 8.2 vs. 3.5 % (p = 0,08). Induced abortion rates were higher in nearly all study groups; they were significantly higher after exposure to clarithromycin, doxycycline and co-trimoxazole. These results suggest that the use of these antibiotics during first trimester of pregnancy causes no significant fetal risks. However, attention should be focussed on exposure to erythromycin and roxithromycin, and further investigation is needed to detect possible small risks. Based on these data there is no indication for induced abortion after exposure to any of these substances. Higher rates of induced abortions possibly indicate that exposed women are scared by warnings on package inserts.
Subject HeadingsAntibiotikum [GND]
Schwangerschaft <1.-3. Monat> [GND]
Antibiotics in pregnancy [MeSH]