Tetracycline teratogenicity

Tetracyclines should be avoided because of teratogenic effects, and sulfonamides should not be administered during the third trimester because of the possible development ofkernicterus and hyperbilirubinemia. Also, the fluoroquinolones should not be given because of their potential to inhibit cartilage and bone development in the newborn. 

Pregnancy All antibiotics cross the placenta. Adverse effects to the fetus are rare, except for tooth dysplasia and inhibition of bone growth encountered with the tetracyclines. However, some anthelmintics are embryotoxic and teratogenic (p. 359). Aminoglycosides should be avoided in pregnancy because of their ototoxic effect in the fetus. 

SAFETY PROFILE A poison by intravenous route. Moderately toxic by ingestion, subcutaneous, and intraperitoneal routes. Human systemic effects by ingestion hemorrhage, dermatitis, and unspecified effects on teeth and supporting strucmres. Human reproductive effects by an unspecified route abnormal postnatal measures or effects. Experimental teratogenic and reproductive effects. Mutation data reported. When heated to decomposition it emits toxic fumes of NOx. See also TETRACYCLINE and various tetracycline derivatives. 

Teratogenic effects of tetracyclines have been demonstrated (158-160), as evidenced by increased rates of intrauterine death, congenital anomalies in general (161), and congenital cataracts (162) in fetuses exposed to tetracyclines. However, it is often impossible to distinguish between the drug and an underlying unidentified viral infection as a cause of the observed abnormalities. 

The authors mentioned that their previous study had not shown a teratogenic potential of doxycycline (164), but concluded, far more prudently, that all tetracyclines are contraindicated during pregnancy. 

Therapy should consist of an agent administered for 7 days that has a relatively low adverse-effect potential and is safe for the mother and baby. The administration of a sulfonamide, amoxicillin, amoxicillin-clavulanate, cephalexin, or nitrofurantoin is effective in 70% to 80% of patients. Tetracyclines should be avoided because of teratogenic effects, and sulfonamides should not be administered during the third trimester because of the possible development of kernicterus and hyperbilirubinemia. In addition, the available fluoroquinolones should not be given because of their potential to inhibit cartilage and bone development in the newborn. A follow-up urine culture 1 to 2 weeks after completing therapy and then monthly until gestation is complete is recommended. 

Ethyl alcohol is found in alcoholic beverages and is a known teratogenic material, which is the reason doctors tell pregnant women not to drink alcohol. When a mother drinks, the unborn child drinks as well. Ethyl alcohol causes growth failure and impaired brain development. Unborn children exposed to alcohol may suffer the effects of Eetal Alcohol Syndrome when they are bom. Symptoms of Fetal Alcohol Syndrome include sleep disturbance, jitteriness, a higher incidence of impaired vision and hearing, lack of motor coordination, balance problems, abnormal thyroid function, and a decrease in immune system effectiveness. Additional teratogens include heavy metals, methyl mercury, mercury salts, lead, thallium, selenium, penicillin, tetracyclines, excess Vitamin A, and carbon dioxide. 

Women comprise 51% of the population of most nations in Western countries, 54% of women are of child-bearing potential (15 9 years). Women account for 57% of physician visits (National Disease and Therapeutic Index ) (FDA, 1986). In the age group 20-39 years, women were found to be the biggest users of anti-infectives, especially ampicillin and amoxicillin antidepressants are prescribed twice as often to women as to men (Stewart, 1998) and of some concern was that tetracycline, a known teratogen, was the eighth most prescribed drug in this group most likely to bear children (FDA, 1986). 

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