妊娠期间服用抗生素是否安全？
回答 Mary Marnach, M.D.
怀孕期间，常常会使用抗生素。但必须谨慎选择特定类型的药物。有些抗生素在孕期可以使用，有些则不能。安全性取决于各种因素，包括抗生素的类型、使用抗生素的妊娠阶段、用药持续时间、用药剂量以及抗生素可能对妊娠产生的影响。
以下抗生素通常被认为可在孕期安全使用：
- 青霉素，包括阿莫西林（Amoxil、Larotid）和氨苄西林
- 头孢菌素，包括头孢克洛、头孢氨苄（Keflex）
- 克林霉素（Cleocin、Clinda-Derm、Clindagel）
有些抗生素被认为在孕期使用会带来风险。例如，四环素类药物可影响骨骼发育以及导致发育中的胎儿牙齿变色。妊娠第 5 周后，不建议使用四环素类药物。磺胺类药物可能带来较低的心脏病、唇裂或腭裂以及黄疸等风险。孕早期和邻近分娩时，通常应避免使用磺胺类药物。
如果抗生素是治疗疾病的最佳方法，医生将以最安全的剂量开最安全的抗生素。如果您对孕期抗生素的使用有疑问或担忧，请告知医生。
显示参考文献
- Landon MB, et al., eds. Drugs and environmental agents in pregnancy and lactation: Teratology, epidemiology, and patient management. In: Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed June 6, 2021.
- Fan H, et al. Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: Population-based cohort study. The BMJ. 2020; doi:10.1136/bmj.m331.
- Lockwood CJ, et al. Prenatal care: Patient education, health promotion, and safety of commonly used drugs. https://www.uptodate.com/contents/search. Accessed June 6, 2021.
- Chestnut DH, et al., eds. Pharmacology during pregnancy and lactation. In: Chestnut's Obstetric Anesthesia: Principles and Practice. 6th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed June 6, 2021.
- Clindamycin. MotherToBaby. https://mothertobaby.org/fact-sheets/clindamycin-pregnancy/. Accessed June 6, 2021.
- Tetracycline. MotherToBaby. https://mothertobaby.org/fact-sheets/tetracycline-pregnancy/. Accessed June 12, 2021.
- Sulfamethozole trimethoprim (Bactrim or Septra). MotherToBaby. https://mothertobaby.org/fact-sheets/sulfamethoxazoletrimethoprim-bactrim-septra-pregnancy/. Accessed June 12, 2021.
- Marnach ML (expert opinion). Mayo Clinic. June 12, 2021.
Original article: https://www.mayoclinic.org/zh-hans/healthy-lifestyle/pregnancy-week-by-week/expert-answers/antibiotics-and-pregnancy/faq-20058542