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Antibiotics safe during pregnancy

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Pregnant women should be advised not to be concerned about taking antibiotics to treat infections, according to the Department of Health, despite new research linking the drugs with an increased risk of cerebral palsy.

A letter, from chief nursing officer for England Dame Christine Beasley, was issued last week in response to publication of the ORACLE Children Study.

‘Media reports on the study findings may cause patients to approach you with concerns about taking antibiotics during pregnancy or in labour,’ states the letter.

The seven-year follow-up study, funded by the Medical Research Council (MRC) and published online in The Lancet, looked at the long-term effects on 3,196 children of the antibiotics erythromycin or co-amoxiclav during pregnancy.

It followed up two previous trials – ORACLE I and II – in which researchers assessed whether the two antibiotics could delay birth by treating an underlying infection that might be causing premature labour.

None of the women in the studies displayed any obvious symptoms of infection.

The follow-up study showed a marginal increase in mild functional impairment among children whose mothers had received erythromycin rather than placebo – 42.3% versus 38.3 % – as well as a slight but significant increase in cerebral palsy risk.

The risk was highest where mothers were given both antibiotics – 4.4% of children had cerebral palsy compared with 1.6% receiving a placebo.

‘The results were unexpected,’ said Dr Catherine Elliott, head of clinical research support and ethics at the MRC.

The CNO’s letter says that, while the findings ‘require further study’, the women in the study had no evidence of infection and would not normally have been prescribed antibiotics.

‘Pregnant women should not feel concerned about taking antibiotics to treat infections.Antibiotics save lives and pregnant women with possible or obvious infections must be considered for treatment with antibiotics,’ it says.

‘This study confirms existing good clinical practice that women in spontaneous pre-term labour with intact membranes should not routinely be given antibiotics,’ it adds.

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