What are key considerations when prescribing antibiotics in pregnancy?

• A. Use tetracyclines as first-line in pregnancy
• B. Avoid tetracyclines and fluoroquinolones
• C. Use fluoroquinolones in pregnancy
• D. Always avoid penicillins

Answer: (B)

Prescribing antibiotics in pregnancy focuses on treating the infection while protecting the fetus from harm. That means choosing drugs with well-established safety in pregnancy and avoiding those with known fetal risks.

Tetracyclines are avoided because they cross the placenta and can affect developing teeth and bones, leading to permanent tooth discoloration and potential growth issues in the fetus. Fluoroquinolones are avoided due to concerns about damage to cartilage development in the fetus, which can affect joints and tendons.

Penicillins are generally safe in pregnancy and are often preferred when appropriate, which is why saying to always avoid them isn’t correct. The key is to balance effectiveness for the mother with safety for the developing baby, selecting the safest effective option and using the narrowest spectrum when possible.