Maternal Use of Antibacterial or Antifungal Drugs for Systemic Use and Infant Congenital Malformations
Most information in the literature based on prospective exposure information shows that the use of common antibacterial drugs is not associated with a significant risk increase for major congenital malformations in the offspring. Two drugs are associated with problems in the offspring: discolored teeth after maternal use of tetracycline exposure after the first trimester and ototoxicity after maternal use of streptomycin and related drugs. Neither phenomenon represents true congenital malformations. An association between maternal use of macrolides (and notably erythromycin) and infant cardiovascular defects has repeatedly been demonstrated from Swedish data but has not been verified in studies from other countries. Methodological problems may explain the difference in results. A number of other associations which have been observed may have been chance findings in spite of formal statistical significance and more data are needed on little used drugs.
Most data on antifungals exist for fluconazole. In moderate doses this drug seems to have no observable teratogenic effect but in high doses (400 mg/day or more), when used for serious fungal infections, it is likely that a teratogenic effect can occur but the magnitude of the risk is not known. Data on other antifungals are less complete but have not shown any definite teratogenicity.
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