Use of Penicillin during Pregnancy

Abstract:

Before starting the article I would like to say that penicillin is not the ‘only’ safe antibiotic to use during pregnancy, because there are few other drugs that can be considered as safe during pregnancy.    

Before starting the article I would like to say that penicillin is not the ‘only’ safe antibiotic to use during pregnancy, because there are few other drugs that can be considered as safe during pregnancy.

Most drugs are contraindicated during pregnancy. This is because most of the drugs that are taken during pregnancy can cross the placenta and enter the fetus. Most of these drugs can act negatively on the fetus, and cause various abnormalities. They can result in morphological abnormalities, as well as growth and developmental abnormalities. Therefore use of any drug during pregnancy should be done with caution.

Drugs are given in order to cure a disease, but what if the patient is pregnant? She should be given medications. We can not keep her without giving any treatments just because she is pregnant. This is where the few drugs that are safe during pregnancy come in to play.

Antibiotics are a class of drugs that are given to cure various infections. As mentioned above most of the antibiotics too can be hazardous to the fetus, but the patient should be given antibiotics, if she acquires a serious infectious disease during pregnancy.  Otherwise the disease it self could be life threatening to the fetus as well as to the mother.

Penicillin plays a major role among the drugs that are safe during pregnancy. It is used in pregnancy without any fear, because there is no evidence of fetal harm from this drug. It is the treatment of choice if the mother acquires any of the following infectious diseases.

Syphilis – This is a disease cause by Treponema pallidum. Protein penicillin is prescribed for primary, secondary or early latent syphilis. It is given 1.2 MU daily, intramuscularly, for 12 days. It should be given for 21 days for later stages of syphilis. Even though this is considered as safe, it can also have some adverse effects. Penicillin causes the death of organisms. Sometimes these dead organisms can trigger the release of pro-inflammatory cytokines, which leads to a Jarish-Herxheimer reaction. As a result the symptoms can become worsen and fever may rise for about a day after starting the treatment. This can also trigger preterm labour, so the mother is admitted to the hospital before starting the treatment.
Group B streptococcus infections – This is an organism that belongs to the normal flora of the gut and the vagina of 20-40 % of the normal women. It can cause upper genital tract infections that could lead to septicaemia, which is detrimental to the mother. Its infections are fatal to the neonate too. Therefore it should be cured by antibiotics. Fortunately penicillin is a safe and effective drug in treating this condition. Penicillin is given intravenously at the time of delivery, after the diagnosis has been made by culture. It is not given in early pregnancy because of common occurrence of re-colonization.
Gonorrhoea – This is a disease caused by Neisseria gonorrhoeae. It is also treated successfully with penicillin.

Even though there are many incidences of penicillin resistance, it is still widely used because of its high effectiveness and safety.

None of the drugs can be considered as safest, but comparing with other drugs, we can say that penicillin is fairly safe.

Finally I would like to say that penicillin is not the only drug that is safe during pregnancy, as the topic implies. Other antibiotics that are considered as safe during pregnancy are Cephalosporin, Erythromycin, and Nitrofurantoin in first and second trimesters.