Table 3.
Preferred antibiotics for treatment of asymptomatic bacteriuria, cystitis and pyelonephritis in pregnancy66
| Drug (Oral) | Dosage | Comments | FDA Category |
|---|---|---|---|
| Nitrofurantoin | 100 mg every 12 hours | Give 5–7 days Common prophylactic agent; avoid in G6PD deficiency and third trimester for risk of hemolytic anemia | B |
| Amoxicillin | 500 mg every 8 hours or 875 mg every 12 hours | Give 3–7 days May have limited utility against gram negative organisms | B |
| Cephalexin | 500 mg every 6 hours | Give 3–7 days Commonly used | B |
| Cefpodoxime | 100 mg every 12 hours | Give 3–7 days | B |
| Drug (Intravenous) | Dosage | Comments | FDA Category |
|---|---|---|---|
| Ceftriaxone | 1 gm every 24 hours | Give 7–14 days Commonly used | B |
| Cefepime | 1 gm every 12 hours | Give 7–14 days Covers Pseudomonas | B |
| Aztreonam | 1 gm every 8 hours | Give 7–14 days In setting of beta lactam allergy | B |
| Piperacillin-tazobactam | 3.375 gm every 6 hours | Give 7–14 days For severe infection | B |
| Meropenem | 1 gm every 8 hours | Give 7–14 days Limited data; for severe infection | B |
G6PD deficiency, glucose-6-phosphate dehydrogenase e deficiency; United States Federal Drug Administration Pregnancy Categories: Category A, adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters);Category B, animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women; Category C, animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks; Category D, there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks; Category X, studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.