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Antibiotic in pregnancy yes or no? The whole truth

Antibiotic in pregnancy yes or no? The whole truth

The use of the antibiotic in pregnancy could cause the onset, in the unborn child, of chronic inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis.

This is what results from a Swedish study that observed 800 thousand children born between 2006 and 2013 and exposed to antibiotic therapy, in gestation or during the neonatal age. In children whose mothers had taken the antibiotic during pregnancy, there was a twice greater risk of developing, during the first years of life, an inflammatory bowel disease, compared to children who had taken antibiotics in childhood. Other possible effects induced by the use of antibiotics during pregnancy are the appearance of asthma and atopic dermatitis.

The reason for this increased risk would be in the microbiome, the set of microorganisms that populates the human intestine responsible for regulating the immune system: its alteration, in this case, caused by contact with antibiotics, which in most cases succeed in crossing the placenta is, in fact, increasingly clearly associated with the development of diseases. Even nutrition, with an abundance of refined and industrial foods, affects the composition of the intestinal microbiome.

Other researches have analyzed and compared the type – quantity and quality – of microorganisms present in the intestines of Tuscan and African children, the latter fed an almost exclusively vegetarian diet. It turned out that the bacterial flora of African children, despite the presence of pathogenic bacteria, was richer in protective microorganisms against inflammation than that of Italian peers.

Antibiotic in pregnancy, how and when

How to behave than in the presence of diseases that require drug therapy, just during pregnancy? The most common infections in pregnancy are urinary, respiratory and sexually transmitted infections.

Failure to treat urinary tract infections or sexually transmitted infections is associated with preterm labor, low birth weight, and miscarriage. It is estimated that about one in four women are prescribed antibiotics during pregnancy and 80% of the drugs prescribed to women at this stage of life are antibiotics.

In the presence of bacterial and non-viral infections, it is, therefore, possible and recommended to take antibiotics, provided they are under strict medical supervision.

According to AIFA, the Italian drug agency, some molecules can be used during the nine months of gestation and during lactation. These are clavulanic acid, amoxicillin, ampicillin, azithromycin, clindamycin, clarithromycin and erythromycin.

In particular, the molecules of amoxicillin and ampicillin are considered the antibiotics of the first choice in pregnancy, while the clindamycin – indicated for example for the treatment of coriamnionite, inflammation of the fetal membranes – is to be used in second place, if the administration of penicillins, cephalosporins and macrolides are not effective. In contrast, tetracyclines and fluoroquinolones are generally to be avoided.


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