Are antibiotics harmful during early pregnancy, which ones can and cannot be taken, which ones are prohibited in the 1st trimester

• Briefly about antibiotics
• Why can't antibiotics be taken during pregnancy?
• What antibiotics are allowed during pregnancy?
• Indications for taking antibiotics during pregnancy

Each expectant mother, along with the news about her situation, realizes that in the coming months she will have to reconsider her lifestyle. Exclusively in the direction of its usefulness. But there are very ambiguous situations. What to do if you get sick? It is clear that this should be avoided, but if it does happen. A pregnant woman should approach the choice of medications with all responsibility and under no circumstances self-medicate.

Briefly about antibiotics

In a few words, we will consider the benefits and harms of antibiotics for any organism. After all, we all know that we shouldn’t just go into using them. This is a very aggressive category of pharmaceuticals. And at the same time very diverse. In any case, antibiotics require a special order of administration - as prescribed by a physician and in accordance with a strict course. In other words, antibiotics can not only be useless, but also cause harm if you prescribe them to yourself at your own discretion. And that's why.

The main effect of any antibiotic is to destroy bacteria. Only bacteria, which means they are useless against viruses and fungi. Is the average person able to “by eye” understand why he is coughing or snotty - because of a virus or because of a bacterium? Hardly. And it’s not so bad if the medicine simply does not act on the causative agent of the disease, but it can affect other aspects of the body’s life!

Most (but not all!) antibiotics are very toxic, some of them have less drastic effects, and only a few are practically harmless. Side effects of antibiotics include stress on the liver, destruction of beneficial microflora (for example, in the intestines or vagina), dysbiosis and disruption of digestive processes, and the development of fungal diseases (candidiasis). Some of them (in particular from the gentamicin group) even affect the functioning of the kidneys and... the inner ear.

Another feature of antibiotics is that to destroy a specific bacterium, a complex of several drugs or a course of a certain duration may be needed. Mismatch and resistance develops! This mysterious word means that the bacteria remains in the body, its activity may have subsided, but the next time (during an exacerbation or relapse) the group of medications used for the first time will be useless. This kind of immunity to a substance is developed by bacteria.

The imperfection of antibiotics lies in the fact that most of them do not particularly understand what bacteria they act against. But beneficial microflora also lives in the human body. And very often it is more sensitive to antibiotics, that is, it dies before pathogens. The use of antibiotics is almost always stressful for the body. Here you need to weigh the pros and cons: is it possible to do without antibiotics, and it’s good if so. If antibiotics are simply necessary (and this is determined exclusively by a specialized physician), then an attentive doctor will certainly prescribe his patient a course of hepatoprotectors and probiotics. Taking antibiotics from time to time is normal, but regularly is harmful. If a person again and again becomes a victim of bacterial infections, the doctor should think about changing the treatment strategy and rather restoring the immune system. Frequent use of antibiotics only undermines it.

Reason for ban

Thus, antibiotics are not such harmless tablets or pills as they might seem at first glance. No qualified doctor would prescribe them without reason, much less to a pregnant woman. At the same time, it cannot be said that taking antibiotics in the early stages of pregnancy is strictly prohibited. Sometimes their help is simply invaluable. And again, prescribing antibiotics is the prerogative of the doctor and no one else!

And that's why:

• These drugs have the ability to penetrate the placenta.
• Antibiotics have an embryotoxic effect, that is, they negatively affect the formation of teeth, kidney function, and contribute to damage to the auditory nerve.
• Pathology in fetal development cannot be ruled out.
• Blood circulation is impaired.
• The growth of the bone structure slows down, and various tissue defects form.

In this regard, only a doctor can make responsible decisions about which drugs can be used without harm to the child.

Why can't antibiotics be taken during pregnancy?

So, antibiotics are not harmless pills at all. They will not be prescribed to anyone without reason, much less to an expectant mother. The statement that are strictly prohibited during pregnancy In some cases you cannot do without them. But again it is the doctor who determines this.

What are the dangers of antibiotics during pregnancy ? Firstly, all of their negative effects listed above remain - a blow to the liver and kidneys (and during pregnancy the load on them is already increased), dysbiosis not only of the intestines, but also of the genital tract, weakening of the immunity of the expectant mother (after all, this is not enough). Secondly, it is especially undesirable to use antibiotics in the first trimester of pregnancy, when the fetus is just forming. The next two trimesters have their own contraindications.

• Antibiotics during pregnancy in the first trimester are dangerous; then a reliable placental barrier has not yet formed around the embryo. The impact of antibiotics and other harmful substances will be the strongest. At this stage, the foundation for the formation of tissues and systems of the future human being is laid. In the first three months, there are practically no antibiotics approved for use, but in each individual case, when choosing a drug, the doctor is guided by the rule “the expected benefit for the mother must exceed the potential risks for her and the fetus.”
• Antibiotics may be prescribed during pregnancy in the second trimester. But not from the category of those that can affect the development of the brain and reproductive system of the fetus.
• Prescribing antibiotics during pregnancy in the third trimester is not much different from the general strategy. Of course, the benefit to the mother and the likelihood of developing pathologies and abnormalities in the fetus are still taken into account. However, the fetus is reliably protected during this period; the placenta does not allow many toxic substances to pass through to it, but not all.

The situation deserves special attention when in the first days or weeks of pregnancy, being unaware of her situation, a woman takes antibiotics. And sometimes completely unacceptable in this period. What to do in fact? General advice - seek advice from a professional who will consider your specific case (what was treated, how was it treated, was it successful, what is the duration and course of pregnancy). Advice in particular - do an ultrasound and blood tests, the doctor will analyze whether the dynamics of pregnancy development are disrupted. Don’t expect the worst, but no one will insist on terminating a pregnancy without a good reason. At the same time, it is necessary to make a reservation that the course of a particular disease in the first days of pregnancy and the use of antibiotics in treatment can “come back to haunt” at a later date, no one is immune from this.

The opinion on the admissibility of an antibiotic during pregnancy is based on the following studies:

• if their toxic effects are proven, the drugs are clearly prohibited;
• if the effect of the drug has not been sufficiently studied and their negative aspects have not been highlighted against this background, then they can be prescribed, but as a last resort;
• If research has proven that there are no side effects on the pregnant woman and the fetus, the antibiotic is allowed to be used if necessary and there are no alternative treatments.

Antibiotics during pregnancy , as in general, are not recommended to be prescribed without a special test for the sensitivity of bacteria to them.
If this is not possible or does not show a clear result, then broad-spectrum drugs are prescribed. This decision lies within the competence of the relevant specialist. He must be informed about the woman’s position, timing and other features of the pregnancy.

Inevitable Consequences

After taking a number of antibiotics in the early stages of pregnancy, the consequences are practically unavoidable. Moreover, it is not the female body that is under their influence, but rather the child due to the ability of the substances to penetrate the placental barrier. Once in the still unformed child’s body, they begin their active work of interacting with the developing internal organs. As a result, their activity causes various pathologies and complications.

To this day, scientists do not stop studying the harmful effects of antibiotics on the intrauterine development of the fetus. But the fact that in the early stages of pregnancy these drugs cause maximum damage has already been proven and no one doubts this.

And if the consequences of antibiotics in the early stages of pregnancy are practically unavoidable, then as for the second and third trimesters, their appearance should not be expected. At this time, the child’s internal organs have already formed, and therefore drugs of this group will no longer cause much harm. At the same time, their use may cause some deviations in the development of the fetus in the future. And to avoid this, you should know which drugs can be used during pregnancy without harm to him.

What antibiotics are allowed during pregnancy?

We came to the conclusion that antibiotics during pregnancy in some cases. Now let's figure out which ones and when:

• absolute contraindications (not allowed under any circumstances):
• tetracycline and doxycycline - easily penetrate the placenta, let alone the first months; accumulate in the bones and tooth buds of the fetus, disrupt mineralization processes, and are toxic to the liver;
• fluoroquinolones (ciprofloxacin, ciprolet, nolicin, abactal, floxal, etc.) are prohibited due to the fact that there is still no reliable basis to assert their safety (no evidence base), at the same time, the ability of substances to damage the joints of the fetus has been established;
• clarithromycin (clacid, fromilid, clubax) and midecamycin, roxithromycin (macropen, rulid) - the safety of use during pregnancy is also not known, there is evidence of toxic effects on the fetus in animals;
• aminoglycosides (kanamycin, tobramycin, streptomycin) - also have a high ability to penetrate the placenta; provoke the risk of complications to the kidneys and inner ear of the fetus, and can cause deafness in the newborn;
• gentamicin - its properties are identical to aminoglycosides, but can be prescribed (better, of course, at a later date) for health reasons and in strictly calculated dosages;
• furazidin (furamag, furagin) and nifuroxazide (ersefuril, enterofuril) - their effect is assessed as potentially dangerous due to the lack of data on the effect on pregnancy;
• chloramphenicol (chloramphenicol, synthomycin, olazol) is prohibited because it passes through the placenta very quickly, and even in high concentrations; negatively affects brain development and disrupts blood cell division; dangerous, among other things, in late stages of pregnancy;
• dioxidine - became prohibited for pregnant women after its toxic and mutagenic effects were proven in experiments with animals;
• co-trimoxazole (Biseptol, Bactrim, Groseptol) - again characterized by penetration through the placenta and in high concentrations; its constituent trimethoprim is an active folic acid antagonist; co-trimoxazole increases the risk of congenital deformities, heart defects, and also slows down fetal growth;

After completing the course of the above listed permitted medications prescribed by the doctor, a second appointment is required to assess the woman’s well-being and repeat examinations.

Indications for taking antibiotics during pregnancy

In general, we can say that the indications for prescribing antibiotics during pregnancy are not much different from the general ones. A competent physician will never just prescribe an antibiotic if you can do without it. The same applies to prescriptions for a pregnant woman. It’s just that the window of opportunity has already opened and we have to make do with only approved medications. In combination with antibiotics, a pregnant woman should be prescribed drugs to prevent dysbiosis, complications of the kidneys and liver, and, of course, immunomodulatory measures.

The most popular group of antibiotics prescribed during pregnancy are penicillins. Ampicillin, amoxicillin, amoxiclav, oxamp - they can actually significantly help the patient. Used by injection and orally. This is a solution for diseases such as sinusitis, bronchitis, pneumonia, pyelonephritis, lymphadenitis.

Antibiotics from the cephalosporin group should be prescribed with greater caution. Ceftriaxone during pregnancy is a strong antibiotic, effective against even the most resistant microorganisms. Therefore, it is most likely to be prescribed for infections of the genitourinary system, respiratory and digestive tract, and skin.

For urogenital bacterial diseases, vilprafen is relevant. Including ureaplasmosis. Ignoring this problem during pregnancy is dangerous for both the woman and the fetus.

Cefazolin is prescribed for extremely strict indications, and then only from the second trimester. They usually manage to cure pneumonia, osteomyelitis, infections of the joints and skeletal system, skin, and urinary system.