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Antibiotics once thought harmful to children in utero now deemed safe by obstetricians, gynecologists

Committee on Obstetric Practice. Obstet Gynecol. 2011; 117:1484-1485.

Crider KS. Arch Pediatr Adolesc Med. 2009;163:978-85.

The National Birth Defects Prevention Study released in 2009 reported that sulfonamides and nitrofurantoins were associated with several birth defects when taken in the first trimester and called for additional scrutiny. This week, a new committee opinion issued by the American College of Obstetricians and Gynecologists reports that these antibiotics are considered appropriate when an alternative is unavailable.

“Antibiotics are commonly prescribed during pregnancy for a variety of bacterial infections, so there is considerable data now on the relationship of antibiotic exposure to birth defects,” William H. Barth Jr., MD, chair of American College of Obstetricians and Gynecologists’ committee on obstetric practice, said in a press release.

Regarding the 2009 study, Barth also said the study had several significant limitations, including patient recall bias, adding that because it was an observational study, it is impossible to know whether the birth defects were caused by the antibiotic, the infection itself or some other factor.

After the first trimester, when the potential risk for these two antibiotics to cause birth defects is lessened, these antibiotics can be used as first-line agents for the prevention of urinary tract infections and other infections, according to the committee opinion statement. As with all patients, antibiotics should be prescribed for pregnant women only for appropriate indications and for the shortest effective duration, according to the statement.

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