Several drugs should be avoided or used with caution because of potential risks during pregnancy, a dermatologist told colleagues.
SAN DIEGO — Multiple topical and systemic medications are safe for treating pregnant women with bacterial, viral, and fungal infections, a dermatologist told colleagues at the annual meeting of the American Academy of Dermatology. However, several drugs should be avoided or used with caution because of potential risks during pregnancy.
Tuberculosis: The best strategy is rifampin , but peripartum vitamin K prophylaxis for mother and fetus should be used, she said.has a secondary skin infection — Murase recommended first-line oral antibiotic therapy with penicillin, first-generation cephalosporins, or dicloxacillin. For second-line therapy, erythromycin is the preferred macrolide over
The combination drug trimethoprim/sulfamethoxazole is a second-line choice for complicated infections because of the associated risk for low birth weight and prematurity, Murase said. and norfloxacin have been studied the most. "If you have to choose a quinolone for a complicated infection in pregnancy, those would be the quinolones of choice," Murase said.
As for systemic antifungal treatments, fluconazole , ketoconazole , and itraconazole should be avoided in pregnancy because of the risks of craniosynostosis, congenital heart defects, and skeletal anomalies, Murase said. However, she referredthat found no increased risk of congenital malformations with fluconazole during the first trimester, and a patient could be reassured if, for example, she was treated for a yeast infection before she knew she was pregnant, she said.
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