Anthrax and Pregnancy

by CDC

(Page 6 of 10)

I'm taking medication to prevent anthrax, and I just found out that I'm pregnant. What should I do?

It is very important that you continue to take as directed the medication you have been prescribed. You should also contact your doctor or local public health officials right away to let them know that you are pregnant. They will want to discuss which medicine would be the best choice for you - to prevent anthrax and to be safe for both you and the fetus.

I'm pregnant. What medicine should I take to prevent anthrax?

You should take medication to prevent anthrax only if a public health official confirms that you have had a potential exposure to anthrax. You and your doctor will want to discuss the risks and benefits of the various antibiotics that can be used to prevent anthrax. Which medicine is most appropriate for you will depend on the specific place and situation of your exposure and on your general medical history (including other medicines you may be taking and any medication allergies you may have). Currently, there are three main antibiotics used to prevent anthrax: ciprofloxacin, amoxicillin, and doxycycline. Ciprofloxacin is effective against anthrax and is unlikely to cause major problems for the fetus, but there is not enough experience or data involving ciprofloxacin during pregnancy to say for certain that there is no risk to the fetus. Doctors are more confident about the safety of amoxicillin for the fetus, but amoxicillin may not always be effective against anthrax. Before prescribing amoxicillin for you, your doctor would want to make sure that the anthrax you were exposed to is not resistant to amoxicillin. Doxycycline can sometimes cause tooth and bone problems in the fetus. Therefore, you should not take doxycycline unless there is a specific reason why you cannot take either ciprofloxacin or amoxicillin.

I've heard that doctors don't generally prescribe ciprofloxacin to pregnant women. Why is that? Why are they recommending it for anthrax prevention?

Ciprofloxacin is not likely to cause major problems for a fetus, but there is not enough experience and data involving ciprofloxacin during pregnancy to say for certain that there is no risk to the fetus. Ciprofloxacin is not commonly used during pregnancy because most infections that pregnant women get can be treated with other drugs whose safety for pregnant women and their fetuses is better documented. However, because anthrax is a life-threatening disease, the benefits of using ciprofloxacin may outweigh potential risks to the fetus.

I was started on ciprofloxacin to prevent anthrax. I've heard that amoxicillin may be a safer drug for me to take during my pregnancy. How do I know if I can be switched to amoxicillin?

Doctors are often more confident about using amoxicillin than ciprofloxacin in pregnancy because they have more information on the safety of amoxicillin for the mother and the fetus. But in some situations, amoxicillin may not be effective against anthrax; this is because the bacteria that cause anthrax can sometimes develop resistance to penicillins such as amoxicillin. Before prescribing amoxicillin for you, your doctor will want to learn more about the specific place and situation of your exposure to anthrax and also about your general medical history. (For instance, some women cannot take amoxicillin because they are allergic to it.)

Doxycycline is being recommended for my coworkers who aren't pregnant. Is doxycycline a better medicine against anthrax than ciprofloxacin?

No. There are no data to suggest that doxycycline is better than ciprofloxacin for preventing anthrax.

I'm having a lot of heartburn during my pregnancy. Can I take ciprofloxacin at the same time as I take antacids?

No. Antacids should not be taken at the same time as ciprofloxacin because they may make ciprofloxacin less effective. (They can interfere with the absorption of ciprofloxacin.) You should not take antacids in the 6 hours before you take a ciprofloxacin pill or for 2 hours after you take ciprofloxacin.

I've been trying to get pregnant and have just started taking medication to prevent anthrax. Can I continue to try to get pregnant while taking this medication?

Whether to try to become pregnant while taking medication to prevent anthrax is your personal decision. When making this decision, you should discuss the possible risks and benefits with your family and your doctor. Some women may prefer to wait until after completing the full course of antibiotics before becoming pregnant. If you decide not to wait, it may be best not to take doxycycline unless there is a specific reason why you cannot take either ciprofloxacin or amoxicillin.

I just recently found out I'm pregnant, and I was exposed to anthrax at work. I want to take the best medication for my fetus and me, but I don't yet want my employer to know that I'm pregnant. What should I do?

It is very important that you tell your doctor or local public health officials that you are pregnant. They will not be required to tell your employer.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.