Your 25-year-old patient is pregnant at 36 weeks gestation. She has an acute urinary tract infection (UTI). Which of the following medications is contraindicated in the treatment of the UTI in this patient?
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Ampicillin
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Nitrofurantoin
3) Trimethoprim/sulfamethoxazole
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Cephalexin
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Amoxicillin/clavulanate
explanation
Tetracycline may cause fetal dental anomalies and inhibition of bone growth if administered during the second and third trimesters, and it is a potential teratogen to first-trimester fetuses. Administration of tetracyclines can also cause severe hepatic decompensation in the mother, especially during the third trimester. Chloramphenicol may cause the gray baby syndrome (symptoms of which include vomiting, impaired respiration, hypothermia, and, finally, cardiovascular collapse) in neonates who have received large doses of the drug. No notable adverse effects have been associated with the use of penicillins or cephalosporins. Trimethoprim-sulfamethoxazole (Bactrim) should not be used in the third trimester because sulfa drugs can cause kernicterus.