Antifungal Therapy During Pregnancy

Careful consideration of the benefit to the mother and the risk to the fetus is required when prescribing antifungal therapy in pregnancy. Imidazoles are considered safe as topical therapy for fungal skin infections during pregnancy. Nystatin is minimally absorbed and is effective for vaginal therap...

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Bibliographic Details
Published in:Clinical infectious diseases 1998-11, Vol.27 (5), p.1151-1160
Main Authors: King, Coleman T., Rogers, P. David, Cleary, John D., Chapman, Stanley W.
Format: Article
Language:English
Subjects:
Abnormalities, Drug-Induced - etiology
Animals
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antifungal agents
Antifungal Agents - adverse effects
Antifungal Agents - therapeutic use
Antifungals
Biological and medical sciences
Clinical Articles
Coccidioidomycosis
Cryptococcosis
Dosage
Female
Fetus
Fetus - drug effects
Fungal infections
Humans
Imidazoles
Infants
Medical sciences
Mycoses - drug therapy
Pharmacology. Drug treatments
Pregnancy
Pregnancy Complications, Infectious - drug therapy
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Summary:Careful consideration of the benefit to the mother and the risk to the fetus is required when prescribing antifungal therapy in pregnancy. Imidazoles are considered safe as topical therapy for fungal skin infections during pregnancy. Nystatin is minimally absorbed and is effective for vaginal therapy. Although vaginal use of the imidazoles is probably safe during the later stages of pregnancy, their systemic absorption is higher than when applied to the skin. The systemic antifungal drug with which there has been the most experience in pregnancy is amphotericin B. There have been no reports of teratogenesis attributed to this agent. There is evidence to suggest that fluconazole exhibits dose-dependent teratogenic effects; however, it appears to be safe at lower doses (150 mg/day). Ketoconazole, flucytosine, and griseofulvin have been shown to be teratogenic and/or embryotoxic in animals. Iodides have been associated with congenital goiter and should not be used during pregnancy.
ISSN:1058-4838
1537-6591
DOI:10.1086/514977