Pregnant + UTI

[northandponce]

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Does anyone know the drug of choice?

In the UK it's nitrofurantoin.

What should I know for Boards?

 

[turkdlit]

Does anyone know the drug of choice?

In the UK it's nitrofurantoin.

What should I know for Boards?

As far as I know you can use either nitro, amoxicillin or a first-gen cephalosporin. I would go with nitro.

 

[slick177]

nitrofurantoin, cephalexin, augmentin, ampicillin, and erythromycin are all good choices.

 

[BMBiology]

Just note that nitrofurantion is contraindicated at term (38-42 weeks gestation), during labor and delivery, or when the onset of labor is imminent.

 

[northandponce]

thanks guys-

so, since I seem to be having brain-freeze (supersaturated at this point)- I was hoping someone could help me compile a list of all the CI meds in pregnancy.

Nothing technical (no need for drugs safe in 1st and not 3rd, vice versa- etc etc.)

Just the obvious ones:
- Valproate and Phenytoin
-Lithium
-Methimazole
- TMP-SMX and I guess most the sulfa drugs, or no?
This is all I can come up with.

Help!! 😉

 

[slick177]

in general most antihypertensives and oral DM meds.

especially ACEI

 

[northandponce]

we can add:

-clindamycin
-fluroquinilones (sp?)

 

[climbingdocs]

Retinoids, Methimazole or any drug for hyperthyroid is category D, but I think they say better to use PTU if u have to. Someone correct me if I am wrong. There is also a mnemonic for bad drugs in pregnancy: SAFE Moms Take Really Good Care:
Sulfa, Aminoglycosides, Fluoroquinolones, Erythromycin, Metronidazole, Tetracyclines, Retinoids, Griseofulvin, Chloramphenicol.
Tommorow is the day!! I just started to freak out....

 

[7abiby]

I thought bactrim (TMP-SMX) was 1st line in pregnant women. I've seen it used quiet often at our hospital

thanks guys-

so, since I seem to be having brain-freeze (supersaturated at this point)- I was hoping someone could help me compile a list of all the CI meds in pregnancy.

Nothing technical (no need for drugs safe in 1st and not 3rd, vice versa- etc etc.)

Just the obvious ones:
- Valproate and Phenytoin
-Lithium
-Methimazole
- TMP-SMX and I guess most the sulfa drugs, or no?
This is all I can come up with.

Help!! 😉

 

[EternalMD]

Generally Cephalosporins or Nitrofurantoin are used. Bactrim is a class C drug so its generally avoided if possible but pyelo in pregnancy doesn't respond well to Nitro (mostly for lower UTI coverage) so I suppose it would be up to the physician to decide if the benefits outweigh the risks

 

[Munchkin6245]

Amoxicillin is first line in UTI for pregnant women.

Add Diuretics to the CI list - it would decrease the amount of amniotic fluid

 

[Ypo.]

Amoxicillin is first line in UTI for pregnant women.

Bingo.