Pregnancy, Ureaplasma, and Antibotics

[froto]

I am 9 weeks pregnant and have been diagnosed with Ureaplasma hominis.  I am living in a 3rd world country where medical treatment is not that good.  The doctor prescribed Zithromax and I am worried that it might hurt my unborn baby.

Would it be better to take Zithromax now or wait longer into my pregnancy.  Also do you recommend another antibotic (antibiotic) other than Zithromax since I am pregnant.

Thanks for you help.
Chris

[Forum-M.D.-DT]

Thank you for visiting the Family Practice Forum.
Ureaplasmal infections are typically sexually transmitted infections. In women, there commonly may be no symptoms, however symptoms such as vaginal discharge, pain with urination (dysuria), increased urinary frequency (polyuria), pelvic pain and pain with intercourse may be present. The treatment of this infection is through the use of antibiotics. Here is what you need to know about Zithromax, and other antibiotics, and pregnancy. Erythromycin and Zithromax are considered "Category B" medications based on the following classification of medication use in pregnancy:

Category A = Safety has been established based on human studies
Category B = Presumed safety based on animal studies
Category C = Uncertain safety, animal studies show an adverse effect, no human studies
Category D = Unsafe. evidence of risk that may in certain clinical circumstances be justifiable.
Category X = Highly unsafe. Risk of use highly outweighs any potential benefit.

Typically, Category B medications are used in pregnancy and are universally felt to be "safe". One reference I used in researching this question (the Merck Manual), made the statement: "Azithromycin's (Zithromax) safety in pregnancy has not been established.

In practice, I can tell you, that provided there was no history of allergy to "Macrolides" (erythromycin, Zithromycin), I have used these medications in pregnant women. The dose of Zithromax to take to treat the infection you describe is 1 gm as a one time dose OR Erythromycin 500mg four times a day for 7 days.

Based on the above classification of the antibiotics and the infection you have with ureaplasma, I would recommend taking Erythromycin 500mg four times a day for 7 days. Like I said, I have prescribed Zithromax in the past in pregnant women, however, with the comment from the Merck Manual, it is safe to say that although Zithromax is a category B medication, there may be some uncertainty about its use during pregnancy.

To summarize ... you should treat this infection now, it is a far greater risk to your baby to NOT treat this infection than it is to take the Erythromycin 500mg four times/day for 7 days. Also, take Erythromycin with food as taking it on an empty stomach tends to cause more stomach upset.
Please let me know if I can be of further assistance.
Dean M. Tomasello, M.D.

[vrishabh]

sirs/madams, hello , my wife is of 24, im 32, she is suffering fm amenorrhea,infertility(disovulatory), amenorrhea is since her maturation periods are highly irregular, weve been married for 3 years no pregnancy yet.. under went lap/hysteroscopy after finding hormone studies as follows on 6 th day of cycle on 28/6/01  t3 = 1.35 ng/ml, t4 = 11.0 mic gr. % TSH = 1.85 mic. unit/ml, ser fsh = 4.4 mIu/ml, ser lh = 6.9 m Iu /ml ser prolactin 8.6 ng/ml
     on 3/7 underwent lap/hysteroscopy, findings as follows
lap findings= ut. anteverted, normal siz\e both tubesw normal both ovaries normal no acherious in pod, no abnormal findings

hysteroscopy = endometrium normal e/servix normal both obtiasern normal on chronic pertubation bill frecspill tnt (adviced tab alcipro, rantre , dilorum sr) later given ocp for one month
and fertotab, on 20/10 , 2nd to 6th day of cycle injection decapeptyl(10days), humog .75 2 amps etc etc..

folicular study on 28/12/01 ,31/12, 2/1/02 and 12/1/02 found rt ovary msf, lt ovary msf  and endometrium  5 to 8 mm
later doc said there is no folicular growth and she is not responded to alll these medicines and inj. her last menstrual period was on 18/12/01, doc says it needs some improvised machines and it takes time as there is a mess in gujarat state (communal violence) so we are waiting for that device to come to that hospital ,
just tell us what step is next that our doc is gonna apply ? and would she concieve or not ? please reply soon