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Antibiotikatherapie in der Schwangerschaft

Antibiotic treatment during pregnancy

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Der Gynäkologe Aims and scope

Zusammenfassung

Bei schwerer Infektionserkrankung der Mutter gibt es keine Kontraindikation für eine Antibiotikabehandlung. Nach heutigem Wissenstand gibt es kaum ein Antibiotikum, welches bei richtiger Anwendung und Dosierung zu einer ernsthaften Schädigung des Kindes führt. Penicilline, Cephalosporine und Erythromycin gehören zu den Antibiotika der 1. Wahl in der Schwangerschaft. Während der Schwangerschaft stellt eine maternale Penicillinallergie eigentlich das einzige therapeutische Problem dar. Sulfonamide, Trimethoprim und Cotrimoxazol sind in der gesamten Schwangerschaft Antibiotika der 2. Wahl. Aminoglykoside, Metronidazol, Lincosamide, Chloramphenicol sowie Glykopeptide sind nur unter strenger Indikation einzusetzen. Tetracycline sollten Schwangere nach der 5. SSW nicht verabreicht werden und gelten als kontraindiziert. Die Gabe von Gyrasehemmern ist ebenfalls bei Schwangeren, Kindern und heranwachsenden Jugendlichen als Vorsichtsmaßnahme kontraindiziert. Eine dennoch erfolgte Behandlung mit kontraindizierten Antibiotika rechtfertigt keinen risikobegründeten Schwangerschaftsabbruch. Letztendlich darf allerdings kein Medikament, Antibiotika eingeschlossen, als absolut unbedenklich bezeichnet werden.

Abstract

There is no contraindications for an antibiotic treatment during severe infection diseases of pregnant women. According to present-day knowledge, no antibiotic treatment with right application and dosage results in a serious impairment of the fetus. Penicillins, cephalosporins and erythromycin belong to the antibiotics of the first choice during pregnancy. During pregnancy a maternal penicillin allergy is actually the only therapeutic problem. Sulphonamides, trimethoprim and co-trimoxazol are antibiotics of the second choice during the entire pregnancy. Aminoglycosides, metronidazol, lincosamides, chloramphenicol and glycopeptides can be used only after strict indication. Tetracyclins are contraindicated and should not be given during pregnancy after the onset of the 5th pregnancy week as a precaution. The use of 4-chinolones is also contraindicated during pregnancy and in children. However, treatment with a contraindicated antibiotic does not justify a interruption of pregnancy. Finally, no medication, including antibiotics, can be considered as absolutely safe.

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Authors and Affiliations

  1. 1. Frauenklinik — Klinikum Innenstadt, Ludwig-Maximilians-Universität München

    I. Mylonas, D. Dian & K. Friese

  2. Klinik für Gynäkologie und Geburtshilfe — Klinikum Großhadern, Ludwig-Maximilians-Universität München

    I. Mylonas & K. Friese

  3. 1. Frauenklinik — Klinikum Innenstadt, Ludwig-Maximilians-Universität, Maistraße 11, 80337, München

    I. Mylonas

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  1. I. Mylonas
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Correspondence to I. Mylonas.

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Mylonas, I., Dian, D. & Friese, K. Antibiotikatherapie in der Schwangerschaft. Gynäkologe 38, 761–770 (2005). https://doi.org/10.1007/s00129-005-1734-9

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  • DOI: https://doi.org/10.1007/s00129-005-1734-9

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