Journal Article

Antifungal Therapy During Pregnancy

Coleman T. King, P. David Rogers, John D. Cleary and Stanley W. Chapman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 5, pages 1151-1160
Published in print November 1998 | ISSN: 1058-4838
Published online November 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514977
Antifungal Therapy During Pregnancy

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Careful consideration of the benefit to the mother and the risk to the fetus is required when prescribing antifungal therapy in pregnancy. Imidazoles are considered safe as topical therapy for fungal skin infections during pregnancy. Nystatin is minimally absorbed and is effective for vaginal therapy. Although vaginal use of the imidazoles is probably safe during the later stages of pregnancy, their systemic absorption is higher than when applied to the skin. The systemic antifungal drug with which there has been the most experience in pregnancy is amphotericin B. There have been no reports of teratogenesis attributed to this agent. There is evidence to suggest that fluconazole exhibits dose-dependent teratogenic effects; however, it appears to be safe at lower doses (150 mg/day). Ketoconazole, flucytosine, and griseofulvin have been shown to be teratogenic and/or embryotoxic in animals. Iodides have been associated with congenital goiter and should not be used during pregnancy.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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