Antibiotics in pregnancy: analysis of potential risks and determinants in a large German statutory sickness fund population

Pharmacoepidemiol Drug Saf. 2006 May;15(5):327-37. doi: 10.1002/pds.1225.


Purpose: Antibiotics are frequently prescribed drugs in pregnancy. The purpose of the study was to analyse the use, the potential risks and the determinants of systemic antibiotic prescriptions during pregnancy.

Methods: A large, nation-wide acting German statutory sickness fund provided prescription data and personal data of 41,293 pregnant women. For this study, all prescriptions of systemic antibiotics (ATC: J01) dispensed to each woman during a 21-month period were analysed. We used the FDA risk classification system and enrolled a literature search to identify potentially harmful antibiotics. To investigate the impact of geographical and socio-economic determinants in antibiotic prescribing, a multivariate logistic regression model was performed.

Results: Of the 41,293 women, 19.7% received at least one antibiotic drug during pregnancy. There was a shift to relatively safe and reduced antibiotic drug use during pregnancy. Prescribing of contraindicated antibactericals or potentially harmful drugs was seen in 521 women (1.3% of all women). In the logistic regression, being younger than 21 years (adjusted OR 2.14, 95%CI 1.80-2.53) or being welfare recipient (adjusted OR 1.57, CI 1.25-2.00) was strongly associated with higher antibiotic use. Significantly lower antibiotic use was seen in 5 of 16 German federal states (OR 0.74-0.83).

Conclusions: About 20% of pregnant women received antibiotics, and 1.3% received a harmful drug. To minimise the risks, detailed guidelines are needed for the antibiotic treatment during pregnancy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Drug-Induced
  • Adolescent
  • Adult
  • Anti-Bacterial Agents / adverse effects*
  • Drug Utilization
  • Female
  • Fetus / drug effects*
  • Humans
  • Logistic Models
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Risk


  • Anti-Bacterial Agents