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The safety of quinolones and fluoroquinolones in pregnancy: a meta-analysis.
Yefet, E; Schwartz, N; Chazan, B; Salim, R; Romano, S; Nachum, Z.
Afiliação
  • Yefet E; Department of Obstetrics & Gynecology, Emek Medical Center, Afula, Israel.
  • Schwartz N; Research Authority and Biostatistics, Emek Medical Center, Afula, Israel.
  • Chazan B; Infectious Disease Unit, Emek Medical Center, Afula, Israel.
  • Salim R; Rappaport Faculty of Medicine, Technion, Haifa, Israel.
  • Romano S; Department of Obstetrics & Gynecology, Emek Medical Center, Afula, Israel.
  • Nachum Z; Rappaport Faculty of Medicine, Technion, Haifa, Israel.
BJOG ; 125(9): 1069-1076, 2018 Aug.
Article em En | MEDLINE | ID: mdl-29319210
BACKGROUND: Quinolones were contraindicated during pregnancy because of concerns regarding fetal malformations and carcinogenesis in animals. The literature is conflicting regarding their safety in humans. OBJECTIVES: To conduct a meta-analysis evaluating the risk for fetal malformations and pregnancy complications following exposure to quinolones during pregnancy. SEARCH STRATEGY: We searched Embase, PubMed, Medline, the Cochrane database, clinicaltrials.gov, and Dart Databases. We added articles found through the references of included articles. SELECTION CRITERIA: Relevant English citations using the terms quinolone/s, fluoroquinolone/s, and pregnancy in humans. Exclusion criteria were case reports, reviews, and articles without data regarding the study outcomes. DATA COLLECTION AND ANALYSIS: Two authors performed the database search, assessment of eligibility, and abstraction of data from included studies. Disagreement was settled by consensus among all authors. The pooled odds ratios (with 95% CIs) were estimated. The Cochrane's Q-test of heterogeneity and I² were used for the measurement of heterogeneity. A total of 256 papers were retrieved, 13 of which met the inclusion criteria and were then analysed. MAIN RESULTS: No association was found between quinolones and fetal malformations (pooled odds ratio, OR 1.08; 95% CI 0.96-1.21), preterm delivery (pooled OR 0.97; 95% CI 0.75-1.24), stillbirth (pooled OR 1.11; 95% CI 0.34-3.6), or miscarriage (pooled OR 1.78; 95% CI 0.93-3.38). CONCLUSIONS: Quinolones are not associated with unfavourable pregnancy outcomes; however, larger studies are needed before safety is established. Until then, it is suggested that quinolones should not be used as a first-line therapy during the first trimester. TWEETABLE ABSTRACT: Quinolones were associated with favourable pregnancy outcomes; caution should be taken in the first trimester.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações na Gravidez / Anormalidades Induzidas por Medicamentos / Quinolonas / Fluoroquinolonas / Antibacterianos Tipo de estudo: Systematic_reviews Limite: Female / Humans / Pregnancy Idioma: En Revista: BJOG Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Israel

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações na Gravidez / Anormalidades Induzidas por Medicamentos / Quinolonas / Fluoroquinolonas / Antibacterianos Tipo de estudo: Systematic_reviews Limite: Female / Humans / Pregnancy Idioma: En Revista: BJOG Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Israel