Is it safe to treat with metronidazole during pregnancy ?/nBackground: A 25-year-old woman from Eth

Fråga: Is it safe to treat with metronidazole during pregnancy ? Background: A 25-year-old woman from Ethiopia is pregnant in week 32. She needs to be treated for an Entamoeba histolytica infection and may have developed liver dysfunction. In addition, she has an increased SR and B-12 deficiency.

Sammanfattning: A treatment course of metronidazole up to 1000 mg/day is considered safe during the latter trimesters. No documentation concerning treatment with higher doses could be found.

Svar: Metronidazole treatment during pregnancy has previously been dealt with in Drugline. First, in vitro studies showed a mutagenic effect of metronidazole, therefore teratogenicity in humans was suspected (1). However, several studies, individual case reports and reviews have described the safe use of metronidazole during pregnancy (2). In summary, a low-dose treatment course up to 1000 mg/day may be considered safe during the second and third trimesters (3). Some investigations have found an increased teratogenic risk when metronidazole is used early in pregnancy (4). No malformations are reported to the Swedish birth register (1). An updated search in Medline and Micromedex revealed no further information.