Key Points Question Are nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-SMX), or fluoroquinolones associated with a higher risk of congenital malformations than β-lactams when used to treat urinary tract infection (UTI) during pregnancy? Findings… Click to show full abstract
Key Points Question Are nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-SMX), or fluoroquinolones associated with a higher risk of congenital malformations than β-lactams when used to treat urinary tract infection (UTI) during pregnancy? Findings In this cohort study of 71 604 pregnancies with first-trimester antibiotic exposure for UTI, the risk of any malformation, severe cardiac malformations, other cardiac malformations, and cleft lip and palate was higher for TMP-SMX vs β-lactams and similar for nitrofurantoin and fluoroquinolones vs β-lactams, after accounting for confounding. Meaning This study suggests that TMP-SMX may be associated with increased risk of malformations; however, no elevated risk was observed for nitrofurantoin.
Journal Title: JAMA Network Open
Year Published: 2025
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