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Drugs should only be prescribed during pregnancy when there are clear indications; the risks of possible adverse side effects in the mother or fetus must be weighed against the likely benefits. Despite this concern, antibiotics are used during pregnancy, including 5% during the first trimester. There are few indications for the prophylactic use of antibiotics in pregnancy, but they are of value in a small number of conditions, such as Lancefield group B streptococcal carriage, recurrent bacteriuria, bacterial vaginosis, premature ruptured membranes, Caesarean section and in pregnant women with known cardiac lesions.
In general, the full adult dose should be used when treating infections in pregnant women and for the prevention of infection prior to surgery. However, low-dose antibiotics for protracted periods of time can be used in the prevention of recurrent bacteriuria. Those antibiotics known to be associated with possible adverse events should be avoided and those antibiotics which have dose-related side effects should be monitored and the dose adjusted accordingly.
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© 1999 Published by Elsevier Inc.