Pregnant women often wonder whether they can take antibiotics in the first trimester of their pregnancy. This depends. Some antibiotics may be considered relatively safe during pregnancy, while others may only be safe when used during a certain time window during pregnancy.

Is It Safe to Take Antibiotics While Pregnant?

It’s not uncommon for women to take antibiotics when pregnant. According to the Centers for Disease Control and Prevention (CDC), 68.9% of women with a urinary tract infection (UTI) filled an antibiotic prescription during pregnancy in 2013-2015. 

Even though it’s relatively common, does that make it safe? Not always.

Taking Antibiotics During Pregnancy

While many antibiotics may be safe during pregnancy, the ones that aren’t can be extremely dangerous. For example, Bactrim and Macrobid treatments during pregnancy have been linked with birth defects, including brain malformations and heart defects. Cleft lips and palates may also be a more significant risk when a woman is prescribed certain antibiotics during pregnancy. 

Unfortunately, research has shown that the most commonly prescribed antibiotics during pregnancy are also the most dangerous. The CDC found that among pregnant women with UTIs in 2014, 4 in 10 were prescribed the antibiotics nitrofurantoin and trimethoprim-sulfamethoxazole in early pregnancy, which have been linked to birth defects. 

Antibiotics considered dangerous during pregnancy are riskiest during the first trimester, and many women are prescribed them before they know they’re pregnant.

Which Antibiotics Are Harmful To Your Baby?

Some of the antibiotics that are generally considered safe during pregnancy include penicillin, cephalosporins, erythromycin, and clindamycin. However, tetracyclines are a type of antibiotic that may not be safe. Tetracyclines aren’t recommended for use after the 15th week of pregnancy because they can discolor a developing baby’s teeth.

Certain antibiotics can be linked to harmful effects on a fetus. For example, sulfonamide antibiotics like Bactrim have been associated with a higher risk of a child being born with hypoplastic left heart syndrome. Specific antibiotics considered unsafe to take during pregnancy can also include ciprofloxacin, Macrobid, and Septra, although this list isn’t exhaustive.

Alternatives To Taking Antibiotics While Pregnant

If a pregnant woman has an infection requiring antibiotic treatment, there are safe alternatives that she may be able to take. A doctor will assess the individual patient, any risk factors she may have, and will work to find an antibiotic that will likely be the safest to take during pregnancy. 

It is important for infections to be treated during pregnancy because not doing so can create its own risks. The American College of Obstetricians and Gynecologists does provide guidelines for health care providers on how to prescribe antibiotics to women during pregnancy. 

It is always recommended to follow a doctor’s prescription exactly to take antibiotics safely. Patients who think they are pregnant or may become pregnant should discuss this with their doctor before taking any antibiotics. 

Why Are Antibiotics Prescribed During Pregnancy?

Some of the infections that can be treated by antibiotics include:

  • Ear and sinus infections
  • Skin infections
  • Dental infections
  • Strep throat
  • Bacterial pneumonia
  • Whooping cough
  • Bladder and kidney infections

There are conditions that women are more likely to get while pregnant that can require antibiotic treatment as well, such as bacterial vaginosis. If a pregnant woman has untreated bacterial vaginosis, it can cause pregnancy complications, including preterm labor, late miscarriage or the development of an infection of the uterus after birth.

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