Cephalosporin antibiotics

(Date: June 2017. Version: 3.1)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What are they?

The cephalosporins are a group of antibiotics that include cefaclor, cefadroxil, cefalexin, cefixime, cefotaxime, cefpodoxime, cefradine, ceftazidime, ceftriaxone and cefuroxime. Cephalosporins are used to treat a wide range of infections. Some are taken by mouth in tablet form, while others are given intravenously (into a vein), usually in hospital.

Is it safe to take cephalosporins in pregnancy?

If not treated, bacterial infections during pregnancy may put both mother and baby at serious risk. 

When deciding whether or not to take a cephalosporin antibiotic during pregnancy it is important to weigh up how necessary this is to your health against the possible risks to you or your baby, some of which will depend on how many weeks pregnant you are. Your doctor is the best person to help you decide what is right for you and your baby.

You should not alter the dose of any of your medicines without medical supervision. Your doctor is the best person to help you decide what is right for you and your baby.

What if I have already taken a cephalosporin antibiotic during pregnancy?

It is always a good idea to let your doctor know that you are pregnant if you have taken any medicines in case you need any additional monitoring or treatment.

This leaflet summarises the scientific studies relating to the effects of cephalosporin antibiotics on a baby in the womb. 

Can taking a cephalosporin antibiotic in pregnancy cause my baby to be born with birth defects?

A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.

Two well-designed studies have investigated whether birth defects were more common in babies born to pregnant women who took a cephalosporin antibiotic in early pregnancy than in babies of women not taking cephalosporins. Neither study found that this was the case.

No well-designed studies have investigated the chance of birth defects in babies exposed to specific cephalosporins.

A number of studies have investigated whether cephalosporin use in pregnancy might increase the likelihood of a specific birth defect in the baby. One study found that use of a cephalosporin antibiotic in early pregnancy may be linked to heart defects in the baby. A second study found a possible link with a specific type of heart defect called an atrial septal defect. A single study has found a possible link between use of cephalosporins in early pregnancy and anorectal atresia (where there is no opening in the baby’s anus). Because in each of these cases results were from just one study, further research is required to assess whether these findings are really due to cephalosporin use in pregnancy or are perhaps explained by other factors.

Can taking a cephalosporin antibiotic in pregnancy cause miscarriage?

A single study found that women taking a cephalosporin antibiotic, or women specifically taking cefalexin in early pregnancy were no more likely to have a miscarriage than women taking a different type of antibiotic, or no antibiotic. Further studies are required to confirm these findings and to investigate the safety of other specific cephalosporins.

Can taking a cephalosporin antibiotic in pregnancy cause stillbirth?

No studies have investigated the likelihood of stillbirth in women taking cephalosporin antibiotics.

Can taking a cephalosporin antibiotic in pregnancy cause preterm birth or my baby to be small at birth (low birth weight)?

A single small study has shown no increased chance of preterm birth or low birth weight in babies exposed in the womb to cefuroxime. More research is required to confirm this finding, and studies into the possible effects of other specific cephalosporins are also required.

Can taking a cephalosporin antibiotic in pregnancy cause learning or behavioural problems in the child?

A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

Two small studies both found no evidence that exposure to a cephalosporin antibiotic in the womb affects a child reaching their developmental milestones up to 18 months of age. Further research is, however, required.

Will my baby need extra monitoring?

As part of their routine antenatal care most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

There is no evidence that taking a cephalosporin antibiotic during pregnancy causes any problems that would require extra monitoring of your baby. 

Are there any risks to my baby if the father has taken a cephalosporin?

We would not expect any increased risk to your baby if the father took a cephalosporin antibiotic before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.



Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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