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The Safety of Quinolones in Pregnancy

Yefet, Enav MD, PhD*; Salim, Raed MD†‡; Chazan, Bibiana MD§¶; Akel, Hiba MSc; Romano, Shabtai MD**††; Nachum, Zohar MD‡‡‡

Obstetrical & Gynecological Survey: November 2014 - Volume 69 - Issue 11 - p 681–694
doi: 10.1097/OGX.0000000000000122

Quinolones and fluoroquinolones are highly efficient antibiotics. However, concerns regarding possible harmful effects have limited their use during pregnancy. Nevertheless, accumulating clinical data suggest that they may be safe during pregnancy.

This review aimed to explore the mechanisms of action of the quinolones and fluoroquinolones, which set the stage for concerns regarding possible teratogenic and mutagenic effects; to clarify the clinical dilemmas that brought forth the necessity in reevaluating the use of those medications during pregnancy; and to review the accumulated data regarding their safety during pregnancy in animal models and humans.

Target Audience: Obstetricians and gynecologists, family physicians

Learning Objectives: After completing this CME activity, physicians should be better able to assess the mechanisms of action that had led to concerns regarding the use of fluoroquinolones during pregnancy, appraise the basic knowledge gained from animal studies about the effects of fluoroquinolones during pregnancy, and analyze the human data on the actual effect of variable fluoroquinolones in pregnancy.

*Resident, Department of Obstetrics & Gynecology, †Head of Labor and Delivery Unit, Obstetrics & Gynecology, Emek Medical Center, Afula; ‡Clinical Assistant Professor, and §Lecturer, Rappaport Faculty of Medicine, Technion, Haifa; ¶Head of Infectious Disease Unit, and ∥Clinical Pharmacologist, The Pharmacology Unit, Emek Medical Center, Afula, Israel; **Associated Senior Clinical Lecturer, Rappaport Faculty of Medicine, Technion, Haifa; and ††Vice Head, Department of Obstetrics & Gynecology, and ‡‡Head of Maternal and Fetal Medicine Service, Obstetrics & Gynecology, Emek Medical Center, Afula, Israel

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: Enav Yefet, MD, PhD, Department of Obstetrics & Gynecology, Emek Medical Center, Yitshak Rabin Boulevard 21, Afula, 18101, Israel. E-mail:

© 2014 by Lippincott Williams & Wilkins.