Considerations for adults with CAP during pregnancy
Amoxicillin, benzylpenicillin and ceftriaxone are safe to use during pregnancy in adults with CAP.
Limited data suggest that if doxycycline is the drug of choice in pregnancy for a serious or life-threatening indication, it should only be used in the first trimester – seek expert adviceCross, 2016.
Azithromycin is considered safe to use in pregnancy if it is the drug of choiceFan, 2020Fan, 2019.
Moxifloxacin is not routinely recommended for use in pregnancy, but if it is the drug of choice for a serious or life-threatening indication, moxifloxacin should be used for the shortest appropriate duration – seek expert adviceChidiac, 2015Acar, 2019Yefet, 2018Ziv, 2018.
The clinical features of CAP and influenza overlap. During pregnancy and up to 2 weeks postpartum, patients with CAP who have suspected influenza are at high risk of severe influenza or complicationsWorld Health Organization (WHO), 2022. Observational data show neuraminidase inhibitor treatment is associated with a reduction in severe outcomes, without increased risk of adverse maternal, fetal or neonatal outcomesChow, 2021. For dosage regimens, see Antiviral therapy for influenza.
The following websites provide updated information on the use of drugs in pregnancy for clinicians, and information in consumer-friendly formats:
- the MotherToBaby website
- the Women’s Pregnancy and Breastfeeding Medicines Guide (subscription required).