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Trimethoprim-Sulfonamide Combination Therapy

Urinary tract infections in pregnancy

Monica Lee, RPh, Pina Bozzo, Adrienne Einarson, RN and Gideon Koren, MD FRCPC

June 2008



My pregnant patients often present with urinary tract infections. Are the medications commonly used for the management of urinary tract infections safe to use during pregnancy?


Existing data indicate that exposure to penicillins, cephalosporins, fluoroquinolones, nitrofurantoin, or phenazopyridine during pregnancy is not associated with increased risk of fetal malformations. Trimethoprim-sulfamethoxazole should be avoided, if possible, during the first trimester of pregnancy because of the antifolate effect associated with neural tube defects.


Il arrive souvent que mes patientes enceintes présentent une infection des voies urinaires. Les médicaments utilisés couramment pour la prise en charge des infections des voies urinaires sont-ils sans risque durant la grossesse?


Les données les plus récentes indiquent que l’exposition à la pénicilline, à la céphalosporine, au fluoroquinolone, à la nitrofurantoïne ou à la phénazopyridine durant la grossesse n’est pas associée à un risque accru de malformations fœtales. Il faudrait éviter dans la mesure du possible le triméthoprime-sulfaméthoxazole durant le premier trimestre en raison de son effet qui est de contrer l’acide folique, associé à des anomalies du tube neural.

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