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Sulfamethoxazole/Trimethoprim (Bactrim® or Septra®)

Selected References: 

  • American College of Obstetricians and Gynecologists. Urinary tract infections in pregnant individuals. Clinical Consensus No. 4. Obstet Gynecol;142:435–45.
  • Ailes EC, et al. 2018. Antibiotics dispensed to privately insured pregnant women with urinary tract infections – United States, 2014. MMWR Morb Mortal Wkly Rep, 67(1):18-22.
  • Andersen JT et al. 2013. Trimethoprim use in early pregnancy and the risk of miscarriage: a register-based nationwide cohort study. Epidemiol Infect, 141:1749-1755. 
  • Cooper M, et al. 2014. Clinical Inquiry: how best to treat UTIs in women who breastfeed? J Fam Pract, 63(2):102-3. 
  • Crider KS, et al. 2009. Antibacterial medication use during pregnancy and risk of birth defects. Arch Pediatr Adolesc Med,163:978-985. 
  • Crowe HM, et al. 2021. Antibiotics and fecundability among female pregnancy planners: a prospective cohort study. Hum Reprod, 18;36(10):2761-2768.
  • Czeizel AE, et al. 2001. The teratogenic risk of trimethoprim-sulfonamides: a population-based case-control study. Reprod Toxicol,15:637-646. 
  • Czeizel AE, et al. 2004. Possible association between different congenital abnormalities and use of different sulfonamides during pregnancy. Congenital Abnormalities, 44:79-86. 
  • Ford N, et al. 2014. Safety of co-trimoxazole in pregnancy: a systematic review and meta-analysis. J Acquir Immune Defic Syndr, 66(5): 512-521.
  • Hansen C, et al. 2016. Trimethoprim-sulfonamide use during the first trimester of pregnancy and the risk of congenital anomalies. Pharmacoepidemiol Drug Saf, 25(2):170-8.
  • Hernandez S, et al. 2000. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med, 343:1608-1614. 
  • Hernandez-Diaz S, et al. 2001. Neural tube defects in relation to use of folic acid antagonists during pregnancy. Am J Epidemiol, 153:961-968. 
  • Klarskov P et al. 2013. Short-acting sulfonamides near term and neonatal jaundice. Obstet Gynecol, 122:105-110. 
  • Li P, et al. 2020. Maternal exposure to sulfonamides and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One, 15(12):e 
  • Molgaard-Nielsen D, Hviid A. 2012. Maternal use of antibiotics and the risk of orofacial clefts: a nationwide cohort Pharmacoepidemiol Drug Saf, 21:246-253. 
  • Murdia A, et al. 1978. Sulpha-trimethoprim combinations and male fertility. Lancet, 2:375-376. 
  • Muanda FT et al. 2018. Use of trimethoprim-sulfamethoxazole during pregnancy and risk of spontaneous abortion: a nested case control study. BJCP, 84(6):1198-1205.
  • NIH-U.S. National Library of Medicine (2021). LABEL: BACTRIM DS- sulfamethoxazole and trimethoprim tablet. (nih.gov) Available at DailyMed https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm. Accessed November 14, 2024
  • Santos F et al. 2011. Exposure to anti-infective drugs during pregnancy and the risk of small-for-gestational-age newborns: a case-control study. BJOG, 118:1374-1382. 
  • Wen SW, et al. 2008. Maternal exposure to folic acid antagonists and placenta-mediated adverse pregnancy outcomes. CMAJ, 179:1263-1268. 
  • Yang J et al. 2011. Exposure to trimethoprim/sulfamethoxazole but not other FDA category C and D anti-infectives is associated with increased risks of preterm birth and low birth weight. Int J Infect Dis, 15:e336- 341. 
  • Yu PA, et al. 2020. Safety of antimicrobials during pregnancy: a systematic review of antimicrobials considered for treatment and postexposure prophylaxis of p Clin Infect Dis, 70(70 Suppl 1):S37-S50. 

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