Aminoglycosides

(Date: March 2017. Version: 1)

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.

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What are they?

The aminoglycosides are a group of antibiotics that are used as ear drops to treat ear infections, eye drops for eye infections, intravenously in hospital for serious infections, and may also be given to clear bacteria from the bowel before bowel surgery. Aminoglycosides available in the UK include amikacin, gentamicin, neomycin, streptomycin, and tobramycin.

Is it safe to use an aminoglycoside in pregnancy?

The timely and correct treatment of potentially severe bacterial infections during pregnancy may be crucial to the health of both mother and baby.

When deciding whether or not to use an aminoglycoside antibiotic during pregnancy it is important to weigh up how necessary this is to your health against the possible risks to you or your baby, some of which will 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.

What if I have already taken an aminoglycoside during pregnancy?

It is always a good idea to let your doctor know that you are pregnant if you have taken any medicines in case you need any additional monitoring or treatment.

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

Can use of an aminoglycoside 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.

One study of pregnant women who took any aminoglycoside in pregnancy provides no proof of a link with birth defects in the baby in general.

A number of studies have investigated the chance of birth defects in the baby following use of specific aminoglycosides in early pregnancy. There is currently no proof that use of gentamicin, neomycin, streptomycin, or tobramycin is linked to birth defects in the baby. However, as these findings are based on small numbers of pregnant women using these medicines, further studies are required to confirm these findings.

Can use of an aminoglycoside in pregnancy cause miscarriage?

There are no published studies that have investigated miscarriage rates following use of aminoglycosides in pregnancy. Research into this subject is therefore required.

Can use of an aminoglycoside in pregnancy cause stillbirth?

No studies have investigated the occurrence of stillbirth following use of aminoglycoside antibiotics in pregnancy.

Can use of an aminoglycoside in pregnancy cause preterm birth or my baby to be small at birth (low birth weight)?

Two small studies found no link between gentamycin use in pregnancy and the baby being born earlier than expected or having a reduced birth weight. More research is required to confirm this finding, and information on other individual aminoglycosides is also required.

Can taking an aminoglycoside in pregnancy cause other problems in the baby/child?

Kidney damage
Use of aminoglycosides can lead to kidney damage in some people. There is therefore a theoretical possibility that use in pregnancy might damage the kidneys of an unborn baby. Although there are case reports of two babies born with kidney defects following exposure in the womb to aminoglycosides there is no proof that their kidney problems were caused by this medicine exposure., A single study found no link between exposure to aminoglycosides in the womb and kidney defects in the baby. Although this provides some reassurance, further research into this subject is, required.

Hearing loss
People carrying certain genes are at increased risk of hearing loss following use of aminoglycosides. There have been case reports of babies born with hearing loss following exposure to aminoglycosides in the womb. In most cases, their mothers also experienced hearing loss following aminoglycoside treatment, suggesting that the risk ran in their family. If you are pregnant and require aminoglycoside treatment, it may be recommended that you have a blood test beforehand to determine whether you carry a gene that increases the risk of hearing loss following aminoglycoside treatment. If you are found to carry the gene, your doctor may suggest the use of an alternative antibiotic if possible.

Learning or behavioural problems
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 studies have investigated learning and development in children exposed to aminoglycosides in the womb. Research into this subject is therefore required.

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 an aminoglycoside during pregnancy causes any problems that would require extra monitoring of your baby.  However, women who have had a serious infection or major surgery during pregnancy may receive additional monitoring to ensure that the baby is growing and developing as expecting.

Are there any risks to my baby if the father has used an aminoglycoside?

We would not expect any increased risk to your baby if the father used an aminoglycoside 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 healthcare provider. They can access more detailed medical and scientific information from www.uktis.org

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WE NEED YOUR HELP! Do you have 3 minutes to complete a short, quick and simple 12 question user feedback form about our bumps information leaflets? To have your say on how we can improve our website and the information we provide please visit www.surveymonkey.co.uk/r/uktis-bumps.

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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