Thursday, February 2, 2023

What Uti Antibiotics Are Safe During Pregnancy

Things To Keep In Mind When Taking Antibiotics During Pregnancy

Which Antibiotics Are Safe During Pregnancy?

The majority of safe antibiotics during pregnancy can be taken with food, which is good news since the most often reported side effect of antibiotics is gastrointestinal distress.

A common reason why women have difficulty taking antibiotics in pregnancy is nausea and vomiting, says Dr. Arbuah-Aning, so do not take antibiotics on an empty stomachtake with food or milk instead.

If youre really struggling, Dr. Arbuah-Aning says your provider can prescribe anti-nausea medication to be taken 30 minutes before taking your antibiotics. In the meantime, you should continue taking your prenatal vitamins and make sure you complete the full course of antibiotics to decrease your risk of prolonged infection and antibiotic resistance.

And remember that if you have any concerns, always feel free to reach out to your prenatal provider.

If youre going to an urgent care doctor or PCP and theyre not sure , check with your OB-GYN, Dr. Ruiz says. Call, send an email, leave a message with the on-call doctordo whatever you need to do.

Group B Streptococcal Infection

Group B streptococcal vaginal colonization is known to be a cause of neonatal sepsis and is associated with preterm rupture of membranes, and preterm labor and delivery. GBS is found to be the causative organism in UTIs in approximately 5 percent of patients.31,32 Evidence that GBS bacteriuria increases patient risk of preterm rupture of membranes and premature delivery is mixed.33,34 A randomized, controlled trial35 compared the treatment of GBS bacteriuria with penicillin to treatment with placebo. Results indicated a significant reduction in rates of premature rupture of membranes and preterm delivery in the women who received antibiotics. It is unclear if GBS bacteriuria is equivalent to GBS vaginal colonization, but pregnant women with GBS bacteriuria should be treated as GBS carriers and should receive a prophylactic antibiotic during labor.36

What Is A Urinary Tract Infection

If you have ever experienced the frequent urge to go the bathroom with painful and burning urination, you have probably experienced a urinary tract infection . UTIs are one of the most common types of infections, accounting for over 10 million visits to health care providers each year. Roughly 40% of women experience a UTI at some time, and in women, it is the most common infection. Healthcare costs related to UTIs exceed $1.6 billion per year.

A urinary tract infection can happen anywhere along your urinary tract, which includes the kidneys , the ureters , the bladder , or the urethra . Most UTIs occur in the bladder and urethra. Common symptoms include frequent need to urinate, burning while urinating, and pain in lower abdomen area.

There are different types of UTIs based on where the bacteria goes. A lower urinary tract infection occurs when bacteria gets into the urethra and is deposited up into the bladder this is called cystitis. Infections that get past the bladder and up into the kidneys are called pyelonephritis.

Urinary tract infection symptoms may include:

  • Pain or burning upon urination
  • A frequent or urgent need to urinate
  • Passing small amounts of urine
  • Blood in the urine or or pink-stained urine
  • Urines that looks cloudy
  • Strong-smelling urine
  • Pain, cramping in the pelvis or pubic bone area, especially in women

Upper UTIs which include the kidney may also present with symptoms of fever, chills, back or side pain, and nausea or vomiting.

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Can A Uti Hurt The Baby While Pregnant

As long as its sufficiently and promptly treated, a UTI isnt expected to hurt your baby during pregnancy. The potential risks to a mother and baby occur when a UTI is left untreated in those cases, the infection can spread to the kidneys, a condition that warrants immediate medical attention.

Most cases of untreated UTIs are caused by asymptomatic bacteriuria. These bacterial infections are less likely to be treated, says Dr. Terry, because there are no obvious signslike pain or bloody urineprompting an expectant mother to call her doctor. You may discover you have asymptomatic bacteriuria at a routine prenatal appointment. Even without symptoms, this type of infection needs to be treated, though, just like a symptomatic UTI.

Although Dr. Terry says UTIs dont cause birth defects or miscarriage, there are still complications that can arise from prolonged infections: Untreated bacteria in the urine is associated with preterm birth and low birth weight of the infant, and kidney infections during pregnancy carry this increased risk, too.

Kidney infections during pregnancy also increase the risk of poor maternal outcomes, says Dr. Terry: These infections have significant risks to the mother, including sepsis or blood infection, anemia, and respiratory distress requiring hospital admission.

Preventing Utis During Pregnancy

Antibiotics Prior to C

While UTIs might happen whatever precautions you take, a few steps can help reduce the odds youll suffer from a UTI during pregnancy:

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

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Common Uti Symptoms In Pregnant Women

While mildly painful urination during pregnancy can often mean a yeast infection, not a UTI, its always best to see your healthcare provider if you experience any symptoms, says Heather Bartos, MD, an ob-gyn in Cross Roads, Texas. After all, research suggests that about 18 percent of UTIs that occur during pregnancy are symptomatic UTIs, meaning the telltale UTI signs and symptoms are present:

  • Strong and frequent urge to use the bathroom
  • Burning while urinating
  • Foul-smelling urine
  • Pelvic pain, usually in the center of the pelvis

In pregnancy, women are also more susceptible to asymptomatic UTIs, meaning you have significant bacteria in your urine but your urinary tract is free of signs and symptoms. Experiencing no symptoms, however, does not mean that asymptomatic UTIs are benign. An asymptomatic UTI can lead to a symptomatic UTI or even a kidney infection, says Dr. Bartos. In fact, research shows that if asymptomatic UTIs are left untreated, 30 percent of pregnant women will go on to develop a symptomatic UTI, and half of those women will eventually be diagnosed with acute pyelonephritis . Up to 23 percent will have a kidney infection recurrence during the same pregnancy. Its important to note that classic UTI signs, like frequent and painful urination, may or may not occur with a kidney infection. Here, some signs to look out for:

What Increases Or Reduces Risk Of Utis During Pregnancy

Women who have or carry the trait for sickle cell disease are at increased risk for UTIs. We test these patients monthly to ensure we detect an infection as soon as possible.

If you have diabetes, youre also at a higher risk. We might not test you as frequently, but we will consistently look for symptoms. Both conditions make it harder for the body to fight infections.

Just as when youre not pregnant, you can take specific actions to lower your chances of getting a UTI, such as:

  • Wiping front to back in the bathroom
  • Urinating before and after sex
  • Wearing cotton underwear
  • Avoiding tight and wet clothing
  • Drinking more water

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Are Antibiotics Safe In Pregnancy

It depends on the antibiotic and how itsclassified by the Food and Drug Administration . Certain antibiotics, like those in the tetracycline class, should always be avoided, as should ciprofloxacin, fluoroquinolones, and streptomycin, among others. Use of these antibiotics during pregnancy has been linked tofetal bone weakening and otherdevelopmental defects.

That still leaves you with a lot of other frontline options, though, many of which are considered safe by OB-GYNs and primary care providers alike.

Most antibiotics are category B drugs, meaning no long-term negative effects have ever been seen and there have been no issues in animal studies, says G. Thomas Ruiz, MD, the OB-GYN lead at MemorialCare Orange Coast Medical Center.

How To Treat A Uti While Pregnant

UTIs During Pregnancy, Prevention and Treatment

UTIs can usually be treated at home with oral antibiotics, but kidney infectionsespecially during pregnancyusually require admission to the hospital for intravenous antibiotics, says Dr. Terry. Its important to distinguish between the two types of infection for treatment, so make sure to tell your doctor if you have any back pain, fever, nausea, or vomiting.

If you have a confirmed UTI, your doctor will prescribe an antibiotic treatment for about three to seven days, says Alisha Reed, Pharm.D., of The FLY Pharmacist.

There are several medications to treat a UTI, and many of them are considered safe to use during pregnancy.

There are some antibiotics that are safe to take during pregnancy benefits outweigh the risks, Dr. Reed says. Most commonly prescribed antibiotics include beta-lactams, cephalexin,amoxicillin, ampicillin, and fosfomycin.

Some antibiotics are prescribed or avoided depending on what trimester of pregnancy youre in Dr. Reed says nitrofurantoin and Bactrim are typically reserved for the second and third trimester and not recommended for the first.

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Why Are Utis Common In Pregnant Women

When youre pregnant, the anatomy of your urinary tract actually changes. For instance, your kidneys become larger and your growing uterus can compress your ureters and bladder. Because of this compression, fully emptying your bladder during pregnancy becomes more difficult. In addition, your progesterone and estrogen levels increase during pregnancy, which can weaken your bladder and ureters. Pregnancy also alters the makeup of your urine, reducing the acidity and increasing the amount of protein, hormones, and sugar in your urine. That excess sugar, for one, can encourage bacterial growth. All of the above contribute to a heightened chance of developing a UTI in pregnancy. And that is why its recommended that all pregnant women receive a urinalysis and urine culture at 12 to 16 weeks or during the first prenatal visit.

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What Is A Uti

A UTI is a bacterial infection of the urinary tract, which includes the bladder , the urethra or, in more serious cases, the kidneys .Trusted SourceNational Institutes of Health, National Library of MedicineWhat causes UTIs & UI?See All Sources

The urinary tract functions to remove waste and extra water from the body. It’s made up of two kidneys, where urine is produced, two ureters, which carry urine to your bladder, the bladder itself, which collects and stores the urine, and the urethra, the tube that sends the urine out of your body.

Changes in both the structure and function of the urinary tract occur in pregnancy, and this can result in increased risks of both UTIs and kidney infections. Bacteria from normal vaginal, perineal and gut flora are the main culprits of UTIs, with E.coli as the most common. Once these bacteria trespass into the urinary tract, they multiply fast, resulting in infection.

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Medications For The Treatment Of Urinary Tract Infection During Pregnancy

Antibiotic medications are frequently used to treat urinary tract infections in women who are pregnant. They are typically prescribed for three to 10 days, depending on the type of medication and the severity of the infection. Common antibiotics that have been approved for the treatment of urinary tract infections during pregnancy include:

  • Penicillins: Penicillins, including amoxicillin, were once the principle treatment of choice for urinary tract infections, but are ineffective against E. coli-driven UTIs in up to 30 percent of cases. They are, however, useful against urinary tract infections caused by other bacteria, such as Staphylococcus saprophyticus or Enterococcus. Stubborn, drug-resistant infections may have to be addressed with Augmentin . Penicillins are typically prescribed for 10 days and are generally well tolerated by most patients. Side effects include diarrhea, nausea, stomach pain, and vaginal itching or discharge.
  • Cephalosporins: Cephalosporins include medications such as cephalexin , cefuroxime and cefadrozil . These antibiotics are currently the most widely prescribed medications for UTIs, but can only be used in the first and second trimesters. Because of their potency, cephalosporins are usually prescribed for three to seven days and are well tolerated. Side effects of these medications include upset stomach, nausea, vomiting, and diarrhea.

Strengths And Limitations Of Study

Nitrofurantoin Dosage For UTI, Kidney Infection

The strengths of this study lie mainly in the method used for data collection. The advantage of using an online forum to collect data was that it provided access to a wide range of participants across the UK. Online forum postings increase the perceived sense of anonymity in participants, which can increase disclosure compared to face-to-face interviews. Data was also immediately available for analysis and circumvented transcription errors arising from interviews.

Using an online forum, however, also contributed to the limitations of this study. Women used descriptive text and emoticons to express their feelings, but using an online forum could result in a loss of insight that facial expressions or verbal tone can offer to exploring perceptions. It was difficult to characterise the exact demographics of website users and only views of women who had access to the internet and had subscribed to the forum could be analysed. Different cultural groups in the UK may also have different norms of behaviour in pregnancy and the views of women from varying backgrounds may differ from what was captured from the forum. Therefore, the interpretation and transferability of the results should be made within this context and broad generalisations may not be appropriate.

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Uti Diagnosis And Treatment

Think you may have a UTI? The standard way to diagnose one is a urine culture. Most doctors will ask for a clean catch sample, where you pee into a cup midstream after carefully wiping your outer vaginal area.

If you are diagnosed with a UTI, your doctor will likely provide a pregnancy-safe antibiotic for seven to 14 days to get rid of all of the bacteria. Be sure to take the recommended full course, even if you start to feel better midway through treatment, and drink plenty of water.

If the infection has reached your kidneys, your practitioner may suggest staying in the hospital, where you can receive IV antibiotics.

Keep in mind: Because an untreated infection can lead to serious complications in pregnancy including kidney infection and, potentially, an increased risk of fetal growth restriction, preeclampsia and preterm birth notify your provider immediately if you have any UTI-like symptoms.

Also remember, not all women have symptoms of a UTI. So, likewise, the urine tests at your regular prenatal visits are really important.

Uti Treatment During Pregnancy

Youâll take antibiotics for 3 to 7 days or as your doctor recommends. If your infection makes you feel uncomfortable, your doctor will probably start your treatment before you get your urine test results.

Your symptoms should go away in 3 days. Take all of your medication on schedule anyway. Donât stop it early, even if your symptoms fade.

Many common antibioticsamoxicillin, erythromycin, and penicillin, for example — are considered safe for pregnant women. Your doctor wouldnât prescribe others, such as ciprofloxacin , sulfamethoxazole, tetracycline, or trimethoprim , that can affect your babyâs development.

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Pregnant women get screened frequently for UTIs with routine urine checks and are treated with antibiotics if bacteria is found in the urine, even if they have no symptoms.

In 2011, the American College of Obstetricians and Gynecologists , the nations leading womens health organization, recommended against the use two types of antibiotics — sulfonamides and nitrofurantoin — in the first trimester of pregnancy, unless there are no other alternatives available .

Sulfonamides include the drug trimethoprim-sulfamethoxazole, also known as Bactrim. Nitrofurantoin is also called Macrobid.

Both of these medications have been associated with birth defects, including brain malformations, heart defects, and cleft lips and palates, in past studies, though more recent studies have shown the link might not be as strong.

In 2017, ACOG revised their committee opinion to state that nitrofurantoin and sulfonamides may be used in the first trimester when no other suitable alternative antibiotics are available.

But with about 35 percent of privately insured first trimester moms getting nitrofurantoin and 8 percent getting the sulfonamide trimethoprim-sulfamethoxazole for treatment of their UTI, it seems that some doctors are not following the recommendations. Those numbers are from a new report released Thursday by the U.S. Centers for Disease Control and Prevention.

Plus, doctors might not be aware of these recommendations, said Ashton.

What Are The Symptoms Of Utis During Pregnancy

Avoid These Antibiotics in the First Trimester of Pregnancy | The Morning Report

Common symptoms of a UTI during pregnancy are similar to those that you might experience at any other time, and include:

  • a burning sensation when you pass urine
  • feeling the urge to urinate more often than usual
  • urinating before you reach the toilet
  • feeling like your bladder is full, even after you have urinated
  • urine that looks cloudy, bloody or is very smelly
  • pain above the pubic bone

Sometimes the first sign of an infection is a faint prickly sensation when you pass urine. If the infection is more advanced and has moved up to the kidneys, you may also experience fever with a particularly high temperature, back pain and vomiting.

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What To Do If You Think You Have A Uti While Pregnant

UTI diagnosis and treatment If you are diagnosed with a UTI, your doctor will likely provide a pregnancy-safe antibiotic for seven to 14 days to get rid of all of the bacteria. Be sure to take the recommended full course, even if you start to feel better midway through treatment, and drink plenty of water.

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