The sixth batch of Mansoura Manchester programme

The sixth batch of Mansoura Manchester programme
Professor: Alaa Mosbah , Mansoura Manchester programme

Wednesday, December 26, 2007

Antibiotics in Pregnancy / DR. Alaa Mosbah . M.D OBS & GYN

Class B: No risk in controlled animal studies Antifungal Topical Agents Amphotericin B Nystatin (Mycostatin) Terbinafine (Lamisil) - not in Briggs (1998) Clotrimazole (Mycelex) Antiparasitic agents Metronidazole or Flagyl (after first Trimester) Avoid single dose therapy Praziquantel - not in Briggs Permethrin (topical) - not in Briggs (1998) Anti-Tuberculosis agents Ethambutol Didanosine - not in Briggs (1998) Antiviral agents Nelfinavir - not in Briggs (1998) Ritonavir Saquinavir Famciclovir Valacyclovir Antibiotics All Cephalosporin Antibiotics (except Moxalactam) All Erythromycin except Erythromycin Estolate Azithromycin (Zithromax) All Penicillin Antibiotics Clindamycin Macrodantin (before third trimester) Sulfa antibiotics (before third trimester) Class C: Small risk in controlled animal studies Antifungal agents Fluconazole (Diflucan) Griseofulvin Itraconazole (Sporanox) Ketoconazole (Nizoral) Antimalarial agents Mefloquine (Lariam) Chloroquine Primaquine Antiparasitic agents Albendazole - not in Briggs (1998) Ivermectin - not in Briggs (1998) Mebendazole Pentamidine Thiabendazole Pyrantel Anti-Tuberculosis agents Dapsone Isoniazid (INH) Pyrazinamide Rifampin Antiviral agents Lamivudine Stavudine Zalcitabine Zidovudine Delavirdine - not in Briggs (1998) Nevirapine Indinavir Cidofovir Foscarnet Ganciclovir Acyclovir Amantadine Rimantadine Interferon alpha Antibiotics Imipenem-Cilastin All Fluoroquinolone antibiotics Clarithromycin (Biaxin) Pediazole - not in Briggs (1998) Sulfisoxazole - not in Briggs (1998) Trimethoprim Vancomycin Chloramphenicol Gentamicin Vaccines Tetanus Toxoid Diphtheria toxoid Polio Vaccine (live and inactivated) Rabies Vaccine Class D: Strong evidence of risk to the human fetus Antiparasitic agents Metronidazole or Flagyl (First Trimester) New evidence suggests first trimester safety Burtin (1995) Am J Obstet Gynecol 172:525-9 Antibiotics Amikacin (Class D per manufacturer) Kanamycin Streptomycin Tobramycin (Class D per manufacturer) Sulfa (Third Trimester) All Tetracycline antibiotics Doxycycline Tetracycline Minocycline Erythromycin Estolate (llosone) Due to hepatotoxicity in pregnant women McCormack (1977) Antimicrob Agents Chemother 12:630 Macrobid and Nitrofurantoin (Third Trimester) Do not use either of these past 38 weeks Can cause Hemolytic Anemia in newborns Related to immature liver and G6PD Deficiency Vaccines Yellow Fever Vaccine Class X: Very high risk to the human fetus Antimalarial agents Quinine Antiviral agents Ribavirin Rebetron - not in Briggs (1998) Vaccines Measles Vaccine Mumps Vaccine Rubella Vaccine Small Pox Vaccine TC-83 Venezuelan Equine Encephalitis Vaccine References Briggs (1998) Drugs in Pregnancy and Lactation, 5th ed Larimore (2000) Prim Care 27(1):35-53

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