임신 중 항생제 사용, Antibiotics during pregnancy
미국 임신부들의 15~40%가 임신 중 항생제로 치료받는다. 항생제 부작용이 임신부, 태아, 테어나는 신생아나 아이에게 생길 수 있다. 그리고 태어난 아기가 모유수유를 할 때도 항생제치료 받는 수유모의 모유 속에 항생제가 분비되어 모유를 먹는 아기에게 항생제로 인한 부작용이 생길 수 있다.
다음은 임신 중 임신부가 항생제로 치료받을 때 항생제의 부작용이 임신부와 태아에 생길 수 있고 없는 정보를 제공한다. 임신 중 임신부가 항생제로 치료 받아야 할 때 참고용 정보이다
미 식약청 FDA 임신 중 항생제 사용 카테고리
A: 임신 제1 삼분기 중 임신부 치료에 쓴 항생제가 태아에게나 임신붕에 위험성을 주지 않는다고 연구된 항생제들.
B; 동물 실험에서 임신한 동물에게 쓴 항생제가 태아에게 위험성을 주지 않는다고 연구결과가 있는항생제들.그러나 사람 임신부에게 이 연구를 하지 안 않았다.
C: 사람 임신부 치료에 임신부, 태아 등에 부작용이 생기는지 않은 항생제들이나 동물 시험에서, 항생제가 부작용이 생기는지 안 생기는지 연구 결과가 없다.
D: 사람 태아에게 유해하다는 증거는 있는 항생제이지만 그 위험성이 생길 가능성이 있는 것을 불구하고 임신부의 치료에 사용하고 있는 항생제이다.
X: 동물 및, 또는 사람 임신에게 연구한 데이터에서 써서 이익을 얻는 것 보다 임신부나 태아에게 확실히 유해한 항생제들이다. 참조 및 소스:HARVARD MEDICAL SCHOOL, INFECTIOUS DISEASES IN PRIMARY CARE OCTOBER 14-16, 2015
1. 안정성이 있다는 항생제 Considered Safe
|
항생제의 종류 |
위험성 |
태아에게 줄 수 있는 부작용 |
|
Natural Penicillin PCNs |
B |
없다고 알려졌음 |
|
Amino-PCNs |
B |
없다고 알려졌음 |
|
Anti-Staph PCNs |
D |
없다고 알려졌음 |
|
Antipseudomonal PCNs |
C |
없다고 알려졌음 |
|
Cephalosporin 1~3세대 |
B |
없다고 알려졌음 |
|
Erythromycin(base, stearate, ethylsuccinate) |
B |
없다고 알려졌음 |
|
Clindamycin클린다마이신(clindamycin)
|
B |
없다고 알려졌음 |
|
Spectinomycin |
B |
없다고 알려졌음 |
참조 및 소스:HARVARD MEDICAL SCHOOL, INFECTIOUS DISEASES IN PRIMARY CARE OCTOBER 14-16, 2015
2. 안정성이 있다고 하지만 주의하면서 치료에 써야하는 항생제 Probably Safe- Use with Caution
|
항생제의 종류 |
위험성의 정도 |
태아에게 줄 수 있는 부작용 |
|
Azithromycin |
B |
없다고 알려졌음 |
|
Aztreonam |
B |
없다고 알려졌음 |
|
Gentamycin |
D |
없다고 알려졌음, 그러나 Aminoglycosides로 청력 장애 및 다른 장애가 있을 수 있다. |
|
Imipenem-cilastatin |
C |
없다고 알려졌음 |
|
Metronidazole메트로니다졸 |
B |
없다고 알려졌음 |
|
Nitropfurantoin |
B |
없다고 알려졌음. 그러나 G6PD 결핍증이 있으면 적혈구 용혈이 생길 수 있다. |
|
Sulfonamides |
B |
G6PD 결핍증이 있으면 적혈구 용혈이 생길 수 있다. |
|
D |
만삭에서는 |
|
|
Trimethoprim |
C |
없다고 알려졌음 그러나 항 엽산작용이 있다. 임신 제1 3분기 동안 쓰지 않음 |
|
Vancomycin |
C |
없다고 알려졌음 |
|
Acyclovir |
C |
없다고 알려졌음 |
|
Amantadine |
C |
쥐 실험에서 태아 기형이 생겼다. |
|
Fluconazole |
C |
150mg 질염 치료용 단 용량 |
|
D |
그 외 모든 다른 이유로 사용할 때 |
참조 및 소스: HARVARD MEDICAL SCHOOL, INFECTIOUS DISEASES IN PRIMARY CARE OCTOBER 14-16, 2015
3.임신 중 일반적으로 금기로 알려진 항생제들 Generally contraindicated
|
항생제의 종류 |
위험성 |
태아에게 줄 수 있는 부작용 |
|
Tetracyclines 테트라싸이클린 |
D |
골 성장지연 및 치아 색소침전 |
|
Fluoroquinolones 플루오로퀸오로니스 |
C |
미숙 동물에서 관절 병변 |
|
Streptomycin 스트렙토마이신 |
D |
청신경 장애 및 농아 |
|
Kanamycin 키나마이신 |
D |
청신경 장애 및 농아 |
|
Erythromycin estolate 에리스로마이신 에 스톨레이트( |
D |
임신부 간 독성 |
참조 및 소스:HARVARD MEDICAL SCHOOL, INFECTIOUS DISEASES IN PRIMARY CARE OCTOBER 14-16, 2015
임신 중 항생제 사용 Antibiotics during pregnancy
15-40% of pregnant women in the United States are treated with antibiotics during pregnancy.
Antibiotic side effects can occur in pregnant women, fetuses, and newborn babies or children.
And even when a born baby is breastfeeding, antibiotics are secreted into the breast milk of a nursing mother who is receiving antibiotic treatment, which can cause side effects from antibiotics to the breastfed baby.
The following provides information on which side effects of antibiotics may or may not occur in the pregnant woman and the fetus when a pregnant woman is treated with antibiotics during pregnancy.
This information is for reference when pregnant women need to be treated with antibiotics during pregnancy.
US Food and Drug Administration FDA Antibiotic use categories during pregnancy
A: Antibiotics studied that antibiotics used to treat pregnant women during the first trimester of pregnancy do not pose a risk to the fetus or pregnancy.
B; Antibiotics, which have been studied in animal experiments, that antibiotics used in pregnant animals do not pose a risk to the fetus, have not been conducted in human pregnant women.
C: There is no research result in whether or not antibiotics have side effects in the treatment of pregnant women in humans or in animal tests or antibiotics that do not cause side effects on pregnant women or fetuses.
D: An antibiotic that has evidence that it is harmful to a human fetus is present, but it is an antibiotic that is used in the treatment of pregnant women despite the potential for its risk.
X: Pregnancy rather than benefiting from the data studied on animal and/or human pregnancy
1. Considered Safe Type of antibiotic
|
antibiotics |
Risk |
Risks Side effects that can be given to the fetus |
|
Natural Penicillin PCNs |
B |
It was known that there was no |
|
Amino-PCNs |
B |
It was known that there was no |
|
Anti-Staph PCNs |
D |
It was known that there was no |
|
Antipseudomonal PCNs |
C |
It was known that there was no |
|
Cephalosporin 1~3 generation |
B |
It was known that there was no |
|
Erythromycin(base, stearate, ethyl succinate) |
B |
It was known that there was no |
|
Clindamycin(clindamycin)
|
B |
It was known that there was no |
|
Spectinomycin |
B |
It was known that there was no |
References and Sources: HARVARD MEDICAL SCHOOL, INFECTIOUS DISEASES IN PRIMARY CARE OCTOBER 14-16, 2015
2. Probably Safe- Use with Caution
| Antibiotics | Risk |
Risks Side effects that can be given to the fetus |
|
Azithromycin |
B |
It was known that there was no |
|
Aztreonam |
B |
It was known that there was no |
|
Gentamycin |
D |
It was known that there was no, but there may be hearing impairments and other disorders as aminoglycosides. |
|
Imipenem-cilastatin |
C |
It was known that there was no |
|
Metronidazole |
B |
It was known that there was no |
|
Nitrofurantoin |
B |
It was known that there was no. However, if there is a G6PD deficiency, hemolysis of red blood cells can occur. |
|
Sulfonamides |
B |
If you have G6PD deficiency, hemolysis of red blood cells can occur. |
|
D |
In term |
|
|
Trimethoprim |
C |
It is not known, but it has anti-folic acid activity. Not used during the first trimester of pregnancy |
|
Vancomycin |
C |
It was known that there was no |
|
Acyclovir |
C |
It was known that there was no |
|
Amantadine |
C |
Fetal malformations occurred in rat experiments |
|
Fluconazole |
C |
150mg a single dose for vaginitis treatment When used for any other reason |
|
D |
When used for any other reason |
References and Sources: HARVARD MEDICAL SCHOOL, INFECTIOUS DISEASES IN PRIMARY CARE OCTOBER 14-16, 2015
3. Generally contraindicated
|
Antibiotics |
Risk |
Risks Side effects that can be given to the fetus |
|
Tetracyclines |
D |
Bone growth retardation and tooth pigmentation |
|
Fluoroquinolones |
C |
Joint lesions in immature animals |
|
Streptomycin |
D |
Auditory nerve disorders and deaf children |
|
Kanamycin |
D |
Auditory nerve disorders and deaf children |
|
Erythromycin estolate Stoleate |
D |
Liver toxicity in pregnant women |
References and Sources: HARVARD MEDICAL SCHOOL, INFECTIOUS DISEASES IN PRIMARY CARE OCTOBER 14-16, 2015