Topic: Antibiotics, antifungals
Question: Chose the appropriate drug giving justifiable reasons. ‘Cotrimoxazole/Cephalexin in prophylaxis of recurrent cystitis in pregnancy’.
Click here for Reference Material-This material is informational alone and is not specifically prepared as an answer for any question. Readers may do their own research before finalising diagnoses according to the characteristics unique to each question. Readers should not proceed without cross-referencing with relevant textbooks as well as standard guidelines available.
For prophylaxis of recurrent cystitis in pregnancy, I would recommend cephalexin over cotrimoxazole.
The justifiable reasons are:
– Cephalexin is a relatively safe antibiotic in pregnancy and is labeled as pregnancy category B, while cotrimoxazole is category C.
– Cephalexin has minimal absorption from the GI tract resulting in low systemic levels. This reduces chances of toxicity to the developing fetus.
– Cotrimoxazole on the other hand can get absorbed systematically and reach high levels which may be harmful.
– Cotrimoxazole is associated with an increased risk of birth defects according to some studies. This is especially a concern in the first trimester.
– Cephalexin is not significantly associated with birth defects or adverse outcomes.
– Both antibiotics are effective for urinary tract infections, but cephalexin has a lower risk profile in pregnancy.
– The benefits of preventing recurrent UTI with prophylaxis likely outweigh the low risks of cephalexin in pregnancy.
In summary, cephalexin would be the preferred choice over cotrimoxazole for antibiotic prophylaxis against recurrent cystitis in pregnant patients due to its safer profile during pregnancy. The risks of cotrimoxazole likely outweigh benefits for this indication
