Antiinfective therapy for pregnant or lactating patients in the emergency department [Clinical Review]

Antiinfective therapy for pregnant or lactating patients in the emergency department Skip to main page content

HOME CURRENT ISSUE PAST ISSUES SUPPLEMENTS REPRINTS ALERTS KEYWORDS GO Advanced Search ? Advertisement
Antiinfective therapy for pregnant or lactating patients in the emergency department Ashley F. Harbison, Derek M. Polly and Megan E. Musselman?

Ashley F. Harbison, Pharm.D., BCPS, is Clinical Pharmacist, The University of Kansas Hospital, Kansas City. Derek M. Polly, Pharm.D., is Clinical Pharmacy Specialist, Pulmonary/Critical Care Medicine, Emory University Hospital–Midtown, Atlanta, GA. Megan E. Musselman, Pharm.D., M.S., BCPS, is Clinical Pharmacy Specialist, Emergency Medicine/Critical Care, North Kansas City Hospital, Kansas City, MO. Address correspondence to Dr. Musselman (megan.musselman{at}nkch.org). Abstract Purpose Special considerations in pharmacotherapy for infectious diseases in pregnant and lactating women in the emergency department (ED) setting are reviewed.

Summary With many women turning to the ED as a source of primary care, it is essential for pharmacists involved in providing ED services to guide the selection of appropriate antiinfective agents during pregnancy and lactation; this area of practice is complicated by the very limited body of published data on the safety and efficacy of maternal antimicrobial use and potential fetal or neonatal adverse effects. Infectious diseases commonly encountered in the ED include sexually transmitted diseases, bacterial vaginosis and other vaginal infections, respiratory and urinary tract infections, and pneumonia. Recommended first-line therapies for pregnant or lactating women may differ from those recommended for other patient populations. Although some widely used antiinfective classes and agents are generally considered safe for use in pregnant women, others (e.g., clarithromycin, fluoroquinolones) have been linked to birth defects and neonatal adverse effects. In addition to guiding ED practitioners in the appropriate use of antiinfective agents in pregnant women and nursing mothers, pharmacists can reinforce the importance of appropriate follow-up care (including specialist referral or culture testing in some cases) and ongoing preventive health measures such as vaccine administration.

Conclusion The use of antiinfective agents in pregnant or lactating women requires consideration not only of the drugs’ effectiveness but also their possible effects on the fetus or newborn and the nature of follow-up care. References are available to help clinicians make treatment decisions.

Copyright ? 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved. CiteULike Delicious Digg Facebook Google+ Reddit Twitter What's this?

? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp130797 American Journal of Health-System Pharmacy February 1, 2015 vol. 72 no. 3 189-197 ? Abstract Full Text Full Text (PDF) Classifications Print Content Clinical Review Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Harbison, A. F. Articles by Musselman, M. E. PubMed PubMed citation Articles by Harbison, A. F. Articles by Musselman, M. E. Related Content Load related web page information Social Bookmarking CiteULike Delicious Digg Facebook Google+ Reddit Twitter What's this?

Current Issue February 15, 2015, 72 (4) Alert me to new issues of American Journal of Health-System Pharmacy From the Cover RhOD immune globulin products for prevention of alloimmunization during pregnancy Sublingual tacrolimus as an alternative to oral administration for solid organ transplant recipients Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective Comparative analytics of infusion pump data across multiple hospital systems ABOUT AJHP SUBSCRIPTIONS FOR AUTHORS/REVIEWERS PERMISSION REQUESTS ADVERTISING EMAIL ALERTS (FREE) RSS FEEDS (FREE) HELP CONTACT US/FEEDBACK American Society of Health System Pharmacists Learning Center (CE) Store Meetings & Conferences ASHP Foundation MOST READ ARTICLES (Last 30 Days) Clinical practice guidelines for antimicrobial prophylaxis in surgery Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists How to write a patient case report Treatment of poisoning caused by {beta}-adrenergic and calcium-channel blockers ? View all Most Read articles Advertisement ? 2015 by the American Society of Health-System Pharmacists. Terms of Use | Copyright Online ISSN: 1535-2900 Print ISSN: 1079-2082

View the original article here