Antibiotics pregnant patients

Nonabsorbable antibiotics are appealing because they have fewer systemic side effects and may be safer for children and pregnant women as well as in patients with renal and hepatic dysfunction. One such antibiotic, aztreonam, showed little effect on anaerobic flora in human volunteers, producing most of its effect on the aerobic flora [49, 50], A trial showed efficacy of aztreonam for traveler s diarrhea, where most pathogens are aerobes [51]. While there are no data on rates of AAD for nonabsorbable antibiotics and C. difficile, these would likely be decreased. Given the preservation of the anaerobic flora, another poorly absorbed antibiotic, bicozamycin, has efficacy in traveler s diarrhea with its major effect being on fecal aerobes [52],... 

Macrolide antibiotics are contraindicated in patients with known hypersensitivity or intolerance to any macrolide. Because clarithromycin can have adverse effects on embryo-fetal development in animals, this drug should be avoided in pregnant women unless no other therapy is appropriate. Concurrent administration of the macrolides and astemizole or terfenadine can cause elected antihistamine levels, resulting in life-threatening cardiac arrhythmias, and should be avoided. 

Pregnant and lactating women and children younger than 8 years should avoid oral doxycycline therapy. In these patients erythromycin base, 500 mg four times daily for 7 days, or amoxicillin, 500 mg three times daily for 7 days, is an alternative to doxycycline. Once systemic therapy has been initiated, topical treatment with lubricants, rasoconstrictors, or a combination antibiotic-steroid may help to relieve the patient s ocular symptoms. 

Procedure Beta-lactam desensitization should be done in an intensive care unit and any concomitant risk factors for anaphylaxis, such as use of beta-blockers should be corrected. Protocols based on incremental use of the drug orally or parenterally have been described (190,193). The oral route is preferable and is associated with a lower incidence of adverse events, but mild transient reactions are frequent (171,194,195). Pregnant women with limited antibiotic choices have been treated with immunotherapy (196). Repeated administration will maintain a state of anergy, which is often lost after withdrawal (197). At the conclusion of therapy, patients must be informed that after withdrawal, they may once again become allergic to penicillin, with a new reaction to the first subsequent application (197). 

Draw patient s attention to the patient information leaflets (PILs) and ask if she has any questions. She asks if she can drink alcohol while taking the antibiotics. What would be your response You should advise the patient that it is alright to drink alcohol while taking amoxicillin tablets. However, if the patient is pregnant, it would be advisable to avoid alcohol during her pregnancy to prevent any harm to the fetus. 

What antibiotics should be avoided if this patient is pregnant ... 

Pregnant women require an increased an amount of iron, but they need to avoid a megadose in the first trimester because it might cause birth defects. Larger doses of iron are necessary in the second and third trimester. Iron is absorbed in the intestine where it enters plasma as heme or is stored as ferritin in the liver, spleen, and bone marrow. Food, the antibiotic tetracychne, and antacids decrease absorption up to 50% of iron. However, the patient should take iron with food to avoid GI discomfort. Vitamin C may slightly increase iron absorption. Iron toxicity is a serious cause of poisoning in children. Toxicity can develop with as few as 10 tablets of ferrous sulfate (3g) taken at one time—and can be fatal within 12 to 48 hours. 

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