Macrolide Use in Pregnancy Associated With Increased Risk in Offspring

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A recent systematic review on macrolide prescribing during pregnancy showed consistent evidence for increased risk of miscarriage but less consistent evidence for increased risk of congenital malformations, cerebral palsy, and epilepsy. Policy advice about the use of macrolides during pregnancy varies across countries.

Macrolide antibiotics taken during the first trimester of pregnancy was associated with an increased risk of any significant malformation and specifically cardiovascular malformations compared with penicillin antibiotics. Macrolide antibiotics taken in any trimester was associated with an increased risk of genital malformations. Macrolide antibiotics should be used with caution during pregnancy, and, if feasible, alternative antibiotics should be prescribed until further research results are available.