USE OF AZITHROMYCIN IN PREGNANCY

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(Date of issue: September 2012, Version: 2.1)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

Summary

Azithromycin is a macrolide antibiotic derived from erythromycin. There are few published data on the use of azithromycin in human pregnancy however the currently available data do not indicate that the use of azithromycin in pregnancy is associated with an increased risk of malformations or adverse pregnancy outcome.  An increased incidence of cardiovascular defects and pyloric stenosis have been suggested for macrolides as a class, although causality has not been established conclusively.

Where possible, the results of culture and sensitivity tests should be available before making a treatment choice. If treatment is required before test results become available, then penicillins along with cephalosporins may be used if considered clinically appropriate. If a macrolide antibiotic is required in pregnancy, erythromycin would be considered the preferred agent as there is more data on its use.  Use of the newer macrolides such as azithromycin should be reserved for compelling indications. 

Exposure to azithromycin at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case specific risk assessments.

This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from TOXBASE.org to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on UKTIS.org.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.