Sulfonamides, Nitrofurantoin Prescribed for UTI in Pregnant Women

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Nitrofurantoin, trimethoprim-sulfamethoxazole prescribed first trimester despite ACOG recs.
Nitrofurantoin, trimethoprim-sulfamethoxazole prescribed first trimester despite ACOG recs.

(HealthDay News) -- For women with urinary tract infections (UTIs), the most frequently prescribed antibiotics during the first trimester are nitrofurantoin, ciprofloxacin, cephalexin, and trimethoprim-sulfamethoxazole, according to research published in the US Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Noting that a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester only when other antimicrobial therapies are deemed clinically inappropriate, Elizabeth C. Ailes, PhD, from the CDC in Atlanta, and colleagues assessed data from the Truven Health MarketScan Commercial Database to examine antibiotic prescriptions filled by pregnant women with UTIs.

The researchers found that during the 90 days before the date of last menstrual period or during pregnancy, 7.2% of the 482,917 pregnancies in 2014 had an outpatient UTI diagnosis. Nitrofurantoin, ciprofloxacin, cephalexin, and trimethoprim-sulfamethoxazole were the most frequently prescribed antibiotics in the first trimester among women with UTIs.

"Given the potential risks associated with use of some of these antibiotics in early pregnancy and the potential for unrecognized pregnancy, women's health care providers should be familiar with the ACOG recommendations and consider the possibility of early pregnancy when treating women of reproductive age," the authors write.

Reference

Antibiotics Dispensed to Privately Insured Pregnant Women with Urinary Tract Infections — United States, 2014. MMWR 2018 January 12;67(1):18–22.

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