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Medicine Chest: Antibiotics in Pregnancy

There are infections that occur in pregnancy that should be treated with antibiotics. This is especially true of infections in the urinary or reproductive tracts, which could impact the health of the baby as well as that of the mother. There are many other, more common, infections occurring during pregnancy in which antibiotics are unnecessary, perhaps even harmful.

The best-known example of infection not requiring antibiotic therapy is the common cold, known as an upper respiratory infection. These infections are almost always caused by viruses, and viruses are not susceptible to antibiotics. Occasionally, the viral upper respiratory infection may "open the door" for bacteria to cause a secondary infection, which doctors call a "superinfection." In such circumstances, opportunistic bacteria may invade the ears (otitis), the sinuses (sinusitis), or the lungs (pneumonia). Each of these infections give obvious symptoms that alert the patient and the doctor to the need for antibiotics.

Although antibiotics are ineffective in colds, many of the most potent antibiotics are still prescribed for these most minor of infections. Some are written under pressure from patients, many are written with a "why not" perspective. The "why not" answer, however, includes cost, side effects, and the growth of increasingly resistant germs.

Now comes another reason to avoid taking antibiotics unless they are necessary. Pediatricians at the University of Nottingham have just reported their results from a long-term study in the United Kingdom of 24,690 children and their mothers. They found that children were more likely to develop asthma, eczema, or hay fever if their mothers had taken antibiotics during their pregnancy. And if the mothers had taken two courses of antibiotics during pregnancy, the likelihood of allergy in children was even greater than those who had only one course of antibiotics.

There are many over-the-counter and prescribed medications that can relieve the symptoms of a cold much more effectively than antibiotics. Pregnant women should seek the advice of their obstetrician and/or pediatrician before taking any OTC or prescription medication.

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Medicine Chest: Antibiotics in Pregnancy

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