Amoxicillin

(Date of issue: July 2012. Version: 2)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Amoxicillin is an antibiotic that is prescribed to treat many different types of bacterial infection including those of the lung, middle ear, and urinary tract (UTIs).

Is it safe to take amoxicillin in pregnancy?

Amoxicillin is commonly used in pregnancy. Most studies have found no link between amoxicillin and poor pregnancy outcome. It is important that bacterial infections in pregnancy are treated early and with an antibiotic that is likely to work. If a bacterial infection is left untreated it can result in serious harm to both mother and baby. Treatment with amoxicillin may therefore be the safest option for you and your unborn baby.

When deciding whether to take amoxicillin during pregnancy it is important to weigh up how necessary amoxicillin is to your health against any possible risks to you or your baby, some of which may depend on how many weeks pregnant you are. Your doctor is the best person to help you decide what is right for you and your baby.

This leaflet summarises the scientific studies relating to the effects of amoxicillin on a baby in the womb. 

What if I have already taken amoxicillin during pregnancy?

If you have taken any medicines it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and to make sure that you are taking the lowest dose that works.

Can taking amoxicillin in pregnancy cause my baby to be born with birth defects?

A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.

No increased risk of birth defects in general has been shown in any of six studies of over 16,000 babies exposed to amoxicillin in the womb.

Two studies suggested a possible link between taking amoxicillin in early pregnancy and having a baby with cleft lip and/or palate, but two further studies did not agree with this finding and more research into this subject is therefore required.

There is currently no strong scientific evidence that taking amoxicillin in pregnancy increases the chance of birth defects in the baby.

Can taking amoxicillin in pregnancy cause miscarriage?

No increased risk of miscarriage was seen in pregnant women taking amoxicillin in the one study that has examined this. However, because miscarriage rates have been studied in only around 150 women taking amoxicillin, more research is required to confirm this finding.

Can taking amoxicillin in pregnancy cause stillbirth?

One study of over 1,000 pregnancies showed no increased risk of stillbirth in women who had taken amoxicillin during pregnancy. Another study of women whose waters had broken early showed that women who were treated with amoxicillin were less likely to have a poor pregnancy outcome (including stillbirth) than women who had not taken amoxicillin.

Can taking amoxicillin in pregnancy cause preterm birth, or my baby to be small at birth (low birth weight)?

Three studies have investigated whether amoxicillin use in pregnancy is linked to preterm birth and low birth weight, with two of these studies finding no links. One study did find that women who took amoxicillin in pregnancy may be more likely to have a preterm and/or low birth weight baby. However, the study could not rule out the possibility that the infections for which these women were taking amoxicillin may explain the higher rates of preterm birth. More research is therefore required before we can say whether the increased risk of preterm birth in this study was linked to amoxicillin or to other factors such as the mother’s health.

Can taking amoxicillin in pregnancy cause learning or behavioural problems in the child?

A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

No link with learning and behavioural problems (e.g. autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD)) is known about in children who were exposed to amoxicillin while in the womb, however no studies have been carried out to specifically investigate this.

Will my baby need extra monitoring during pregnancy?

As part of their routine antenatal care most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

There is no evidence that taking amoxicillin during pregnancy causes any problems that would require extra monitoring of your baby. 

Are there any risks to my baby if the father has taken amoxicillin?

We would not expect any increased risk to your baby if its father took amoxicillin before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.  

General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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