The primary outcome was the number of miscarriages and offspring with major congenital malformations among users of clarithromycin compared to non-users. Results: We identified pregnancies live births, 77 miscarriages, and induced abortions. The hazard ratio HR of having a miscarriage after exposure to clarithromycin was 1. There was no increased hazard of having a miscarriage when being exposed to penicillin or erythromycin.
The results are similar to other studies addressing the same issue both in human and animals. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. National Center for Biotechnology Information , U. PLoS One. Published online Jan 2. Colin Simpson, Editor. Author information Article notes Copyright and License information Disclaimer. Competing Interests: All authors have declared that no competing interests exist.
Received May 14; Accepted Nov This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. This article has been cited by other articles in PMC. Abstract Background The antibiotic clarithromycin has been associated with fetal loss in animals and a study has found a doubling in the frequency of miscarriages among women using clarithromycin in pregnancy.
Methods We conducted a nationwide cohort study including all women in Denmark with a known conception between and Results We identified pregnancies live births, 77 miscarriages, and induced abortions. Conclusions We found an increased hazard of miscarriage but no increased prevalance of having offspring with malformations among women redeeming a prescription of clarithromycin in early pregnancy.
Introduction Clarithromycin is a macrolide antibiotic used to treat common infections including respiratory tract infections, skin infections and helicobacter pylori infections. Statistics All data management and analyses were performed using SAS software, version 9.
Ethics All data were linked in computers held by Statistics Denmark and were made available with encrypted personal information. Results We included pregnancies identified within the study period.
Miscarriage In the pregnancies exposed to clarithromycin in the first trimester, 40 Major Congenital Malformations Among the women exposed to clarithromycin in the first trimester resulted in live births. Table 1 Basic characteristics. Open in a separate window. Table 2 Exposure to clarithromycin in the first trimester. Other Analyses To investigate if the increased hazard of having a miscarriage when exposed to clarithromycin could be confounded by indication, we tested for the hazard of some drugs typically used for respiratory infections in Denmark.
Figure 1. The hazard ratio of having a miscarriage when redeeming a prescription of a drug in the first trimester of pregnancy. Figure 2.
The hazard ratio of having a miscarriage when redeeming a prescription of clarithromycin in the first trimester of pregnancy directly compared to the hazard of women redeeming prescriptions of different drugs used in similar conditions.
Table 3 Sensitivity analyses. Adjusted hazard ratios of having a miscarriage when redeeming a prescription in the first trimester compared to unexposed. Number of exposed Number of unexposed Hazard ratio unadjusted Hazard ratio adjusted Erythromycin 1.
Discussion We found an increased hazard of having a miscarriage when redeeming a prescription of clarithromycin in the first trimester of pregnancy. References 1. Abbott Laboratories Biaxin product information. Am J Perinatol 15 — : Anonymous Better news on population. Lancet : Newtownabbey Co Antrim: University of Ulster. He noted the study only included children whose mothers were prescribed an antibiotic for a respiratory tract infection.
Log in below to join the conversation. Login to comment. Any suggestions for treating chlamydia in early pregnancy, in light of this information? More clinical guidance. Related Calls for GPs to have greater role in maternity care. Facing harsh truths: Antibiotics in modern general practice. GPs and their central place in maternity care.
If it helps, eat smaller meals more often than usual. Snack when you're hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts. Eat smaller meals, eat and drink slowly, and exercise.
There are pharmacy medicines that can also help, such as charcoal tablets or simethicone. Ask a pharmacist for advice.
Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller if you need one. Talk to your doctor if the headaches last longer than a week or are severe.
Try not to watch television or use your mobile phone before going to bed. Instead, try to relax for an hour before bedtime. Non-urgent advice: Tell your doctor if you're:. There are some medicines that don't mix well with clarithromycin. Tell your doctor if you're taking these medicines before you start clarithromycin: ergotamine and dihydroergotamine - used to treat migraines medicines for epilepsy , such as carbamazepine and phenytoin theophylline for asthma colchicine for gout digoxin - for some heart problems warfarin - to thin blood or prevent blood clots a statin medicine to lower your cholesterol - such as simvastatin and atorvastatin Mixing clarithromycin with herbal remedies and supplements There are no known problems with taking herbal remedies or supplements alongside clarithromycin.
Important: Medicine safety Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. How does clarithromycin work? Clarithromycin is from a group of medicines called macrolide antibiotics. Macrolide antibiotics work by killing the bacteria causing the infection.
When will I feel better? What if I don't get better? Tell your doctor if you don't start feeling better after taking clarithromycin for: 3 days for a chest infection 7 days for cellulitis Also tell them if, at any time, you start to feel worse. How does clarithromycin compare with other antibiotics?
All macrolides can be used to treat chest and skin infections. Can I drink alcohol with it? Yes, you can drink alcohol with clarithromycin.
Will it give me thrush? Ask your pharmacist or doctor for advice if this happens to you. Will it stop my contraception working? Look on the pill packet to find out what to do. Will it reduce my fertility? Is there any food or drink I need to avoid? You can eat and drink normally while taking clarithromycin. Related conditions Cellulitis Chest infection Ear infections.
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