There is no doubt that pregnancy is a beautiful feeling. However, it is complicated too. During this period, women need to avoid certain foods, take immense care of their bodies and carefully watch the medicines they consume. The incorrect dose could very well lead to a miscarriage. Read further to find out whether one such medication- Azithromycin- is safe for pregnant females or not!
What is Azithromycin, And What does it Treat?
Azithromycin is an antibiotic that treats specific bacterial infections. In the year 1991, this drug was approved by the Food and Drug Administration. Like most antibiotics, Azithromycin cannot treat all types of bacteria. Hence, it is all the more important to consult a doctor before you begin a course.
Is Azithromycin Safe For Pregnancy?
Pregnant mothers might contemplate taking Azithromycin in pregnancy. If necessary, then Azithromycin can be taken by expectant mothers under the advice of a doctor. First trial studies on animals did not find an increased risk of miscarriage or congenital disabilities on taking large doses of Azithromycin.
However, high-quality studies on a large number of pregnant women have not been conducted yet. This is why the prescription label on the packaging states that "Azithromycin should be used during pregnancy if needed."
Hence, if a pregnant woman falls sick due to a bacterial infection, she can take the medication if advised by her doctor.
In a nutshell, yes, Azithromycin may be safe for pregnancy. Yet, there has been no high-quality studies around pregnant women to verify this thoroughly. Hence the drug label presently states- "azithromycin should be used during pregnancy only if clearly needed." So, it's advisable that you consult your doctor first before taking Azithromycin during pregnancy. It's always better to be safe than sorry!
Also read: Is breast leakage during pregnancy normal?
Is Azithromycin Safe in Early Pregnancy?
Yes, Azithromycin may be safe in early pregnancy. It is classified as pregnancy class B, which means animal reproduction studies have failed to indicate a risk to the fetus, and that there aren't sufficient and well-controlled studies in pregnant women. However, always consult with a doctor first before taking Azithromycin during pregnancy.
Azithromycin Pregnancy Category
Azithromycin pregnancy category is class B. This means that animal reproduction studies have failed to indicate a risk to the fetus, and that there aren't sufficient and well-controlled studies in pregnant women.
Side Tip: Always consult with a doctor first before taking Azithromycin during pregnancy.
Azithromycin Uses In Pregnancy
Doctors may prescribe Azithromycin in pregnancy to a woman for the treatment of acute bacterial infections. The usage of Azithromycin is usually clinically indicated for the following conditions:
- Community-acquired pneumonia (an infection that inflames the lungs air sacs), caused by S. pneumonia, Chlamydia pneumonia, Haemophilus pneumonia.
- Sinus infection due to Streptococcus pneumonia.
- Chronic Obstructive Pulmonary Disease (COPD) is a disease in which chronic inflammation of the lungs causes obstructed airflow.
- Skin infections related to Staphylococcus aureus, Streptococcus pyogenes (bacterias).
- Tonsillitis, an infection where there is inflammation of the tonsils.
- Urethritis, an infection where there is inflammation of the urethra.
- Cervicitis, an infection that results in inflammation of the end of the uterus.
- A study in animals indicated that Azithromycin could inhibit Lipopolysaccharide (LPS)-induced pregnancy loss. LPS is a compound that causes inflammation and triggers abortion and preterm births.
Azithromycin in Pregnancy Dosage
Azithromycin in pregnancy dosage will vary depending on what infection you have. It's advisable that your always consult a doctor online or offline, before taking Azithromycin in pregnancy for any medical condition. Pregnant women can take Azithromycin with or without food.
Side Tip: Thoroughly shake the liquid form before use.
| Infection | Dosage |
|---|---|
| Community-Acquired Pneumonia Tonsillitis Skin Infection | Initial Dose of 500 Milligrams (mg) Followed by 250 Milligrams (mg) Daily for 5 Days |
| Mild-to-Moderate Bacterial COPD Exacerbations | 500 Milligrams (mg) Daily for 3 Days Or Initial Dose of 500 Milligrams (mg) Followed by 250 Milligrams (mg) Once Daily Until Day 5 |
| Sinus Infection | 500 Milligrams (mg) Per Day for 3 Days |
| Chancroid Genital Ulcers | Single Dose of 1 Gram (g) |
| Urethritis Cervicitis | Single Dose of 1 Gram (g) |
| Gonococcal Urethritis Cervicitis | Single Dose of 2 Gram (g) |
Should You Use Azithromycin During Pregnancy Third Trimester
Yes, you can use Azithromycin during pregnancy third trimester. It has been suggested that exposure to Azithromycin during pregnancy is not associated with an increase in the rate of significant abnormalities in pregnant women. However, consult with your doctor first before using Azithromycin during pregnancy.
Azithromycin belongs to the macrolide group of antibiotics. It has not been associated with an increased risk of malformation in animal studies. Most studies of women who took macrolides have not provided any evidence linking birth defects in babies to the use of the medication. However, it's important to note that only a few women have been tested for these results.
Can Azithromycin Cause Miscarriage?
Are you toying with an idea to take antibiotics during pregnancy and wondering can Azithromycin cause miscarriage? As per studies, certain types of antibiotics during pregnancy may cause miscarriage. However, the study does not validate its cause and effect.
Some antibiotics seem to be safer when it comes to the risk of miscarriage, while other antibiotics seem to be riskier. As far as Azithromycin is concerned, it belongs to the subclass of macrolide antibiotics that are associated with a 65 per cent (twofold) increased risk related to miscarriage.
Azithromycin in Lactation & Breastfeeding: Is it Safe?
Azithromycin may transfer into the breast milk and remain present for about 48 hours from your last dose. While Azithromycin in lactation is usually safe but it is best to consult a medical health expert to avoid any adverse effect.
Is Azithromycin Safe during Breastfeeding?
Although studies haven't suggested any adverse effect on babies, and it is generally safe to use when breastfeeding, Azithromycin still may cause mild health problems such as diarrhoea, vomiting, or a rash in some babies. So, there's no direct answer to whether Azithromycin is absolutely safe during breastfeeding. But normally it doesn't cause any serious damage and can be considered safe in lactation and during breastfeeding.
How To Use Azithromycin?
One can take Azithromycin during pregnancy orally with or without food. If you have an upset stomach, take the medication after eating. Take the entire dosage as directed by your doctor. It is essential to take Azithromycin for the duration prescribed to ensure its effectiveness. Usually, doctors recommend that you take Azithromycin once daily at the same time.
Don't stop taking the medication if you feel better, as doing this can allow bacteria to continue growing, resulting in a return of the infection. Consult your doctor if your symptoms worsen. Set a reminder to ensure that you remember to take Azithromycin daily.
Antacids often contain aluminium or magnesium and may decrease the absorption of Azithromycin. If you are on an antacid, have it at least 2 hours before or after having Azithromycin.
Azithromycin Side Effects
We have listed the most crucial azithromycin effects below. However, this might not be a comprehensive list. Consult your doctor to learn more.
- Nausea
- Vomiting
- Diarrhoea
- Abdominal pain
- Irregular heartbeat
- Acid reflux
- Headache
- Fatigue
- Dizziness
- Rashes
- Chest pain
- Dry skin
Azithromycin Precautions
- Women with a history of allergy to macrolides or ketolides should not take the medication.
- Women with a previous condition of myasthenia gravis that causes muscle weakness might face worsening symptoms or breathing problems after taking Azithromycin.
- One cannot prescribe this medication to treat pneumonia if a woman has bacteremia, cystic fibrosis or an underlying immune system issue.
- Women should not rely on Azithromycin to treat syphilis.
- If a woman suffers from an irregular heartbeat or existing kidney and liver disease, they should consult a doctor before taking this medication.
- Azithromycin can be detected in breast milk and may remain for 48 hours after a woman's last dose. Generally, it is safe to use Azithromycin when breastfeeding, but the drug may cause diarrhoea, vomiting or a rash in babies.
Are Drugs Safe During Pregnancy?
Some drugs are considered safe to consume during pregnancy. However, there are a few medicines whose effects on an unborn child have not yet been studied. Some medications are harmful to the baby when taken during the first few months of pregnancy.
A few drugs, like tetracycline, can be absorbed by an unborn child, and it can cause side effects. Hence, it is essential to consult a doctor before taking medication while pregnant. Most doctors think that using Azithromycin is safe in pregnancy.
As stated above, human studies have not linked miscarriage or birth defects to the usage of the medication. However, since studies have been conducted on small groups, the data is not entirely conclusive. Hence, always take Azithromycin during pregnancy only if needed and directed by your doctor.
Also read: Amla during pregnancy
In a Nutshell, Should You Use Azithromycin in Pregnancy?
Azithromycin is safe to use during pregnancy in most medical expert opinions. Complications during pregnancy, miscarriage, and potential harm to the fetus have not been linked to using this medicine. However, only commence an Azithromycin course if your doctor has recommended it. This is because, like all drugs, Azithromycin also has side effects that could negatively affect certain pregnant women's body conditions.
FAQs
Is Azithromycin an Antibiotic?
Yes, Azithromycin is an antibiotic medicine. It belongs to a group of medicines named macrolide antibiotics that kill the infection-causing bacteria.
Azithromycin is used to treat various infections that include chest infections such as pneumonia, sinus infection (sinusitis), skin infections, Lyme disease, and also sexually transmitted infections (STIs). It is available on prescription as liquids, capsules, and tablets that you can swallow and can also be taken by injection, which is usually done in the hospitals.
Which Antibiotics Are Safe During Pregnancy?
A few antibiotics are safe during pregnancy and hence can be prescribed, while a few being unsafe, cannot be prescribed. Safety depends on a multitude of factors such as type of antibiotic, time to take the antibiotic and for how long and how much to take, and the possible harm it can have on your health.
Here is the list of antibiotics that are generally considered safe during pregnancy:
- Penicillin that includes amoxicillin (Amoxil, Larotid) and ampicillin
- Cephalosporins that includes cefaclor and cephalexin (Keflex)
- Clindamycin (Cleocin, Clinda-Derm, and Clindagel)
Which Antibiotic Is Not Safe in Pregnancy?
Certain antibiotics pose certain risks during pregnancy. These include:
- Sulfonamides might affect heart health, may lead to jaundice as well.
- Tetracycline, that tends to affect bone development and discolour teeth of a developing baby.
Therefore, it is important to choose a safer medication or an older drug with a proven track record in pregnancy. Moreover, narrow-spectrum antibiotics are preferred over broad-spectrum antibiotics in the treatment of infections and intrapartum GBS (Group B β-hemolytic Streptococcus) chemoprophylaxis. The use of empiric broad-spectrum antibiotics is best avoided.
Can I Take Azithromycin 500mg Twice a Day?
You may take Azithromycin 500 mg once a day but only after consulting your doctor. Always remember the dose of this medicine will be different for different patients.
The dose of any medicine that you take depends on its strength. Also, the number of doses per day, the time allowed between doses, and the length of time you take a medicine depend on your medical condition. Therefore, it is recommended to follow health expert’s or doctor's advice.
References
Moumita Sarkar, Cindy Woodland (2006) Pregnancy outcome following gestational exposure to Azithromycin (National Library of Medicine) https://pubmed.ncbi.nlm.nih.gov/16734900/
Ayse Er (2013) Azithromycin Prevents Pregnancy Loss: Reducing the Level of Tumor Necrosis Factor-Alpha and Raising the Level of Interleukin-10 in Rats" (Mediators of Inflammation) https://www.hindawi.com/journals/mi/2013/928137/
Elif Keskin-Arslan, May 2020; Use of azithromycin during pregnancy and breastfeeding: A coronavirus pan-demic (COVID-19) update - https://motheriskinternational.com/use-of-azithromycin-during-pregnancy-and-breastfeeding-a-coronavirus-pan-demic-covid-19-update/
