Concerns regarding the safety of azithromycin in pregnancy - relevance for women with cystic fibrosis

Jennifer L Taylor-Cousar; Raksha Jain; Tracy M Kazmerski; Moira L Aitken; Natalie E West; Alexandra Wilson; Peter G Middleton; Edward F Nash

doi:10.1016/j.jcf.2020.08.003

Concerns regarding the safety of azithromycin in pregnancy - relevance for women with cystic fibrosis

J Cyst Fibros. 2021 May;20(3):395-396. doi: 10.1016/j.jcf.2020.08.003. Epub 2020 Aug 12.

Authors

Jennifer L Taylor-Cousar¹, Raksha Jain², Tracy M Kazmerski³, Moira L Aitken⁴, Natalie E West⁵, Alexandra Wilson⁶, Peter G Middleton⁷, Edward F Nash⁸

Affiliations

¹ National Jewish Health, Internal Medicine and Pediatrics, Pulmonary, 1400 Jackson Street, J318, Denver 80206, CO, USA. Electronic address: taylorcousarj@njhealth.org.
² Internal Medicine, Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA.
³ Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
⁴ Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
⁵ Johns Hopkins University, Division of Obstetrics and Gynecology, Baltimore, MD, USA.
⁶ National Jewish Health, Clinical Research Services, Denver, Colorado, USA.
⁷ Westmead Clinical School, University of Sydney, Sydney, Australia.
⁸ West Midlands Adult Cystic Fibrosis Centre, University Hospitals Birmingham NHS Foundation Trust, Bordesley Green East, Birmingham, UK.

PMID: 32800485
DOI: 10.1016/j.jcf.2020.08.003

Abstract

Chronic oral azithromycin therapy improves clinical outcomes in people with cystic fibrosis (CF), and is recommended for treatment of CF lung disease. Azithromycin is categorized as pregnancy class B. The data for risk of congenital malformations associated with use of azithromycin during pregnancy ranges from no risk to a small increased risk. As with other chronic medications used to treat CF, potential risk to the infant of use of azithromycin during pregnancy must be weighed against the potential risk to the mother of treatment discontinuation. Women with CF considering pregnancy while on chronic azithromycin should be counseled regarding potential risks and benefits.

Keywords: Azithromycin; Congenital malformations; Macrolide; Pregnancy.

Publication types

Letter
Research Support, Non-U.S. Gov't

MeSH terms

Administration, Oral
Anti-Bacterial Agents / administration & dosage
Anti-Bacterial Agents / adverse effects*
Azithromycin / administration & dosage
Azithromycin / adverse effects*
Cystic Fibrosis / drug therapy*
Cystic Fibrosis / microbiology*
Female
Humans
Pregnancy
Pregnancy Outcome
Prenatal Exposure Delayed Effects*
Risk Factors

Substances

Anti-Bacterial Agents
Azithromycin