Not all antibiotics can be used in pregnancy:
Some drugs also cross into breastmilk.
Detailed information is available in the BNF, and on the UK Teratology Information Service website.
The following antibiotics have decades of extensive use in pregnancy and breastfeeding patients, and are considered generally safe:
| Cell wall agents | • Beta-lactams (Penicillins, Cephalosporins, Carbapenems) • Vancomycin & Teicoplanin | | --- | --- | | Protein Synthesis Blockers | • Gentamicin • Erythromycin • Clindamicin | | Other | • Metronidazole • Standard TB drugs • Topical agents: Mupirocin, Fusidic acid |
For more detail, and for information on other agents, see the table below.
| Item | Authors | DoI/link | Notes |
|---|---|---|---|
| List of commonly used ABx | GP Notebook | https://gpnotebook.com/simplepage.cfm?ID=-1033175035&linkID=62274 | |
| List of ABx that are safe to treat whilst breastfeeding | Breastfeeding Network | https://www.breastfeedingnetwork.org.uk/factsheet/antibiotics/ | Charity with pretty good advice on breastfeeding |
| Sepsis in Pregnancy GTG 64a | RCOG | https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/sepsis-in-pregnancy-bacterial-green-top-guideline-no-64a/ | |
| A Review of Antibiotic Use in Pregnancy | Bookstaver et al | https://doi.org/10.1002/phar.1649 | Good primer on ABx use in pregnancy, including the old/new FDA classification of risk |
| Drugs and Lactation Database | LactMed | https://www.ncbi.nlm.nih.gov/books/NBK501922/ | |
| Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: population based cohort study | Fan et al | https://doi.org/10.1136/bmj.m331 | Comprehensive review of macrolides |
| Safety in Breastfeeding, Infection and infectious diseases | UKDILAS: UK Drugs In Lactation Advisory Service | https://www.sps.nhs.uk/?s=&orderby=&order=DESC&cat[]=3008&cat[]=2980 | SPS advisory service on antibiotics in breastfeeding |
| Let's talk breastfeeding: what clinicians need to know | Dr Anastasia Theodosiou | https://www.hellomicro.org/post/breastfeeding | Tash’s website! |
| UKTIS (UK Teratology Information Service) | https://uktis.org/ | Definitive resource on medicines and pregnancy/breastfeeding | |
| BUMPs (Best Use of Medicines in Pregnancy) | UKTIS | https://www.medicinesinpregnancy.org/ | Patient-facing version of the UKTIS website. |