SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Safety of Antimicrobials During Pregnancy: A Systematic Review of Antimicrobials Considered for Treatment and Postexposure Prophylaxis of Plague.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Non-genetic risk factors of miscarriage: a comprehensive umbrella review of systematic review and meta-analysis.Reproductive health · 2025Pooled it
- Tularemia Antimicrobial Treatment and Prophylaxis: CDC Recommendations for Naturally Acquired Infections and Bioterrorism Response - United States, 2025.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2025Guideline
- A systematic review of the clinical profile of patients with bubonic plague and the outcome measures used in research settings.PLoS neglected tropical diseases · 2023Pooled it
- Antimicrobial Treatment and Prophylaxis of Plague: Recommendations for Naturally Acquired Infections and Bioterrorism Response.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- Hidradenitis Suppurativa from Preconception to Lactation: Clinical Treatment Decision-Making Review.Dermatology and therapy · 2026Review
- Eravacycline as a Novel Option for Treating Multidrug-Resistant Gram-Negative and Gram-Positive Bacterial Infections: A Narrative Review.Journal of clinical medicine · 2026Review
- Two Cases of Q Fever in Pregnancy, including Management of the Newborn, Australia.Emerging infectious diseases · 2026Review
- Expanding treatment options for syphilis during pregnancy: a review of alternatives to penicillin.Frontiers in global women's health · 2026Review
- Prevalence and factors associated with the irrational use of antibiotics by pregnant women in the city of Marrakech, Morocco: a cross-sectional study.BMC pregnancy and childbirth · 2025Article
- Influence of perinatal antibiotic on neonatal gut microbiota: a prospective cohort study.BMC pediatrics · 2025Article
- A Guide to the Management of Hidradenitis Suppurativa in Pregnancy and Lactation.American journal of clinical dermatology · 2025Review
- A review of antibiotic safety in pregnancy-2025 update.Pharmacotherapy · 2025Review
- Association Between In-Utero Exposure to Antibiotics and Offspring's Hearing Loss: A Systematic Review and Meta-Analysis.Children (Basel, Switzerland) · 2025Review
- Developmental exposure of antibiotics shortens life span and induces teratogenicity inToxicology reports · 2024Article
- First Trimester Tetracycline Exposure and Risk of Major Congenital Malformations.JAMA network open · 2024Article
- Antibiotic Use in Pregnancy: A Global Survey on Antibiotic Prescription Practices in Antenatal Care.Antibiotics (Basel, Switzerland) · 2023Article
- Tularemia in Pregnant Woman, Serbia, 2018.Emerging infectious diseases · 2023Article
- Evidence for Implementation: Management of TB in HIV and Pregnancy.Current HIV/AIDS reports · 2022Review
- Safety of Antimicrobials for Postexposure Prophylaxis and Treatment of Anthrax: A Review.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Review
- An Exploration ofFoods (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe safety profile of antimicrobials used during pregnancy is one important consideration in the decision on how to treat and provide postexposure prophylaxis (PEP) for plague during pregnancy.
methodsWe searched 5 scientific literature databases for primary sources on the safety of 9 antimicrobials considered for plague during pregnancy (amikacin, gentamicin, plazomicin, streptomycin, tobramycin, chloramphenicol, doxycycline, sulfadiazine, and trimethoprim-sulfamethoxazole [TMP-SMX]) and abstracted data on maternal, pregnancy, and fetal/neonatal outcomes.
resultsOf 13 052 articles identified, 66 studies (case-control, case series, cohort, and randomized studies) and 96 case reports were included, totaling 27 751 prenatal exposures to amikacin (n = 9), gentamicin (n = 345), plazomicin (n = 0), streptomycin (n = 285), tobramycin (n = 43), chloramphenicol (n = 246), doxycycline (n = 2351), sulfadiazine (n = 870), and TMP-SMX (n = 23 602). Hearing or vestibular deficits were reported in 18/121 (15%) children and 17/109 (16%) pregnant women following prenatal streptomycin exposure. First trimester chloramphenicol exposure was associated with an elevated risk of an undescended testis (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.2-28.7). Doxycycline was associated with cardiovascular malformations (OR 2.4, 95% CI 1.2-4.7) in 1 study and spontaneous abortion (OR 2.8, 95% CI 1.9-4.1) in a separate study. First trimester exposure to TMP-SMX was associated with increased risk of neural tube defects (pooled OR 2.5, 95% CI 1.4-4.3), spontaneous abortion (OR 3.5, 95% CI 2.3-5.6), preterm birth (OR 1.5, 95% CI 1.1-2.1), and small for gestational age (OR 1.6, 95% CI 1.2-2.2). No other statistically significant associations were reported.
conclusionsFor most antimicrobials reviewed, adverse maternal/fetal/neonatal outcomes were not observed consistently. Prenatal exposure to streptomycin and TMP-SMX was associated with select birth defects in some studies. Based on limited data, chloramphenicol and doxycycline may be associated with adverse pregnancy or neonatal outcomes; however, more data are needed to confirm these associations. Antimicrobials should be used for treatment and PEP of plague during pregnancy; the choice of antimicrobials may be influenced by these data as well as information about the risks of plague during pregnancy.
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Registered trials
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