Re: Rational use of Antimicrobials in pregnancy and lactation

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Dear Dr Trupti and all, In pregnancy and lactation, as far as possible, drugs can be avoided. Where there is need, we should go for safer one like Penicillin group or Erythromycin and the ones given in list of WHO (antibiotics safe in pregnancy). Treatment of TB and/or HIV occuring with pregnancy should be not be stopped but continued. THINK GLOBALLY, BUT ACT LOCALLY AND RATIONALLY. Anupama.Trupti Swain <drtruptiswain@...> wrote: Friends Use of Antimicrobials in pregnancy and lactation becomes important because of - A state of immunological paradox - Structural changes in smooth muscles of the genitourinary system - Poly-microbial nature of the infections The parturient stands vulnerable to microbial infections much more than her non-pregnant counterpart. Most infections are due to aerobes, anaerobes, genital mycoplasmas and even Chlamydia trachomatis most of which pre-exist as commensals in the vaginal tract. Should treatment with anti-microbial have to be expeditious and have to be instituted without waiting for the isolation? Quite frequently Gynaecologist goes for empirical treatment and clinical response. Sometimes there can be diagnostic dilemma particularly in emergencies. Caution must however always be taken regarding the adverse effects of any anti-microbial to the mother and her fetus or

neonate during pregnancy and lactation. Hyper-sensitivity, direct toxicity and suppression of normal flora have to be considered for each of the antimicrobial instituted. Adequate renal function would regulate dosage and selection of the anti- microbials in therapy. Drugs declared safe by American Academy of Pediatrics Committee on Drugs are penicillins, cephalosporins, macrolides, clindamycin, cotrimoxazole, isoniazid, ethambutol, rifampicin, quinine, quinidine and acyclovir. As Dr Mahadev T Desai has pointed in his presentation, “We should think globally but act

locally” we need to develop our own set of essential antimicrobials to be used for pregnancy and lactational period taking into account local sensitivity pattern. Trupti Be a better friend, newshound, and know-it-all with Mobile. Try it now.

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