Antibiotic use in pregnancy

A research paper published in PLOS ONE has found no overall association between antibiotic use in pregnancy and cerebral palsy and/or epilepsy in childhood.  This supports current NHS practice, recommended by NICE, which is to treat infections using antibiotics when medically indicated, as infections in pregnancy can result in very poor maternal and neonatal outcomes.

Secondary analysis in the paper indicates some increase in risk with the use of a specific type of antibiotics, macrolides.  However the Royal College of Obstetricians and Gynaecologists have released a statement saying that there does not need to be a change in prescription practises:

Professor Alan Cameron, RCOG Vice President for Clinical Quality, says:  “We welcome any new research which sheds light on the safety of antibiotics in pregnancy. The secondary analysis in this paper has shown a small increase in cerebral palsy and/or epilepsy with prenatal use of macrolides but it does not consider the severity of the maternal infection which, in turn, has an effect on the outcome. This level of evidence does not warrant a change in current clinical guidelines. Doctors should continue to prescribe erythromycin during pregnancy where indicated.”

PLOS ONE research can be found here

RCOG statement here