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Common Antifungal Drugs in Pregnancy: Risks and Precautions

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Abstract

Fungal skin infections are on the rise in India, and pregnant women are not immune to them. They are one of the commonest causes of secondary pruritus in pregnancy and can worsen the quality of life. Cutaneous dermatophytic infections have seen a recent emergence as a public health problem in India with increasing incidence as well as failure to appropriately respond to treatment. Vaginal candidiasis may cause obstetric and perinatal complications such as chorioamnionitis, premature rupture of membranes, preterm labor and neonatal candidiasis. Antifungal drugs are commonly prescribed in pregnancy. The common oral antifungals used are fluconazole, ketoconazole, itraconazole, terbinafine and griseofulvin; whereas the common topical antifungals are azoles, ciclopirox oleamine, terbinafine, amongst others. There have been reports of congenital abnormalities in the fetus and spontaneous abortions attributed to oral antifungals. Prescribing antifungal drugs in pregnancy needs careful consideration. In this article, we discuss the safety profile and recommendations regarding the use of these drugs during gestation. We have performed a literature search of recent large-scale cohort, case-control, and meta-analysis studies and presented them in this review. Antifungals such as echinocandins, amphotericin B, flucytosine, etc. which are indicated for systemic mycoses are beyond the scope of this article. Finally, we have given authors’ perspective regarding the justifiable use of these antifungals in pregnant women.

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Authors and Affiliations

  1. N. Wadia Hospital, Parel, Mumbai, India

    Madhuri A. Patel (Hon. Clinical Associate)

  2. Police Hospital, Mumbai, India

    Madhuri A. Patel (Hon. Clinical Associate) & Veeral M. Aliporewala (Hon. Consultant)

  3. Sion, Mumbai, India

    Madhuri A. Patel (Hon. Clinical Associate) & Veeral M. Aliporewala (Hon. Consultant)

  4. Department of Community Medicine at TNMC, BYL Nair Charitable Hospital, Mumbai, India

    Disha A. Patel (M.D. (Community Medicine)

Authors
  1. Madhuri A. Patel
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  2. Veeral M. Aliporewala
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  3. Disha A. Patel
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Correspondence to Veeral M. Aliporewala.

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We, the authors of this study declare that no patient identity is revealed and we have no conflict of interest or financial interests for this article.

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Dr. Madhuri A. Patel is an Hon. Clinical Associate at N. Wadia Hospital, Parel, Mumbai, India; Hon. Consultant at Police Hospital Mumbai, India and Visiting Consultant at St. Elizabeth and Masina Hospitals, Mumbai, India. Dr. Veeral M. Aliporewala is an Hon. Consultant, Police Hospital, Mumbai and Practising dermatologist at Sion, Mumbai, India. Dr. Disha A. Patel is an Assistant Professor in Department of Community Medicine at TNMC and BYL Nair Charitable Hospital, Mumbai, India.

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Patel, M.A., Aliporewala, V.M. & Patel, D.A. Common Antifungal Drugs in Pregnancy: Risks and Precautions. J Obstet Gynecol India 71, 577–582 (2021). https://doi.org/10.1007/s13224-021-01586-8

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  • DOI: https://doi.org/10.1007/s13224-021-01586-8

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