Title: Which antibiotics should be used with caution in pregnant women with UTI? | MDedge ObGyn
Headings: Which antibiotics should be used with caution in pregnant women with UTI?
Expert Commentary
Which antibiotics should be used with caution in pregnant women with UTI?
EXPERT COMMENTARY
Details of the study
Antibiotic-associated effects
Study strengths and weaknesses
References
Next Article:
This Publication
Specialty Focus
Top Sections

Content: 2017;130 (3):e150–e152. doi:10.1097/AOG.0000000000002300. EXPERT COMMENTARY
Lower urinary tract infection (UTI) is one of the most common medical complications of pregnancy. Approximately 5% to 10% of all pregnant women have asymptomatic bacteriuria, which usually antedates the pregnancy and is detected at the time of the first prenatal appointment. Another 2% to 3% develop acute cystitis during pregnancy. The dominant organisms that cause lower UTIs in pregnant women are Escherichia coli, Klebsiella pneumoniae, Proteus species, group B streptococci, enterococci, and Staphylococcus saprophyticus. One goal of treating asymptomatic bacteriuria and acute cystitis is to prevent ascending infection (pyelonephritis), which can be associated with preterm delivery, sepsis, and adult respiratory distress syndrome. Another key goal is to use an antibiotic that eradicates the uropathogen without causing harm to either the mother or fetus. In 2009, Crider and colleagues reported that 2 of the most commonly used antibiotics for UTIs, sulfonamides and nitrofurantoin, were associated with a disturbing spectrum of birth defects. 1 Following that report, in 2011 the American College of Obstetricians and Gynecologists (ACOG) published a committee opinion that recommended against the use of these 2 agents in the first trimester of pregnancy unless other antibiotics were unlikely to be effective.